What is POLST?

The POLST form is a medical order indicating a patient’s wishes regarding treatments that are commonly used in a medical crisis. As a medical order, emergency personnel – such as paramedics, EMTs, and emergency physicians – must follow these orders. Without a POLST form, paramedics and EMTs are required to provide every possible medical treatment to sustain life. Since the POLST is a medical order, once your health care professional signs it, it means that your treatment wishes will be known and should be followed during a medical emergency, regardless of where you are.

POLST is also helpful in guiding treatment after the initial emergency. The brightly colored form gives you a way to tell doctors, nurses, and other health care professionals what types of treatment you do and do not want. It is important that POLST orders show what treatments you want now, in your current state of health.

Advance care planning is different for each person. Everyone must think about their values and what is important for them at the end of their life. POLST is not for everyone; POLST is only for those individuals diagnosed with serious advanced illness. This section of the website will help you determine if POLST is something that would be helpful for you or for a loved one.

How do I use a POLST form?

The original POLST form always remains with the patient, regardless of whether the patient is in the hospital, at home, or in a nursing home. In a health care facility the form will be in the medical record. In a home setting the form should be placed in a visible location recognized by emergency medical personnel (usually the side or front of the refrigerator).

Some Medical Terms Used in POLST form

Advance Directives
Advance Directives are written instructions stating how you wish your medical decisions to be made if you become unable to make decisions for yourself. Sometimes Advance Directives are called living wills. Most states allow patients to appoint a person to make health care decisions on their behalf when patients cannot speak for themselves.

Antibiotics treat some infections (such as pneumonia) that can develop when a person is seriously ill. Antibiotics may also treat symptoms (such as with a bladder infection).

Artificial nutrition
When a person can no longer eat or drink by mouth, liquid food can be given to them by tube.

Cardiopulmonary resuscitation (CPR)
CPR attempts to restart breathing and/or the heartbeat of a person who has no heartbeat and/or has stopped breathing. It typically involves “mouth-to-mouth” and forceful pressure on the chest to restart the heart. This procedure may also involve electric shock (defibrillation) or a plastic tube down the throat into the windpipe to assist breathing (intubation).

Comfort measures
Comfort measures describes care that is undertaken with the primary goal of keeping a person comfortable (rather than prolonging life). On the POLST form, a person who requests “comfort measures only” would be transferred to the hospital only if needed for his or her comfort.

Intravenous (IV) fluids
IV fluids are administered directly into the vein via a small plastic tube (catheter). Typically, they are given on a short-term basis.

Mechanical ventilation/respiration
When a person is no longer able to breathe on his/her own, a plastic tube is put down the throat and a machine pumps air in and out of the lungs through the tube.

Tube feeding
On a short-term basis, fluids and liquid nutrients can be given through a tube in the nose that goes into the stomach (nasogastric or “NG” tube). For long-term feeding, a tube can be inserted though a surgical procedure directly into the stomach (gastric or “G” tube) or the intestines (jejunal or “J” tube).

Medical decision-maker
If you are unable to make decisions for yourself, most state laws allow a family member or designated surrogate to serve as your representative and make decisions for you. If you have completed a medical power of attorney or health care proxy, the person designated on that form will be your legal health care representative.

Source: http://www.polst.org

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