I'm Dr. Joshua Schwimmer, a nephrologist and internal medicine physician in New York City. • Kidney Notes was the first active nephrology blog. (Trivia: Kidney Notes is so old that the National Library of Medicine still uses it as an example of how to formally cite blogs.) • Professionally, you can find me at Kidney.nyc. • Kidney Notes is for educational purposes only, not medical advice. Consult qualified health care professionals. See disclaimer.

Thursday, May 18, 2006

While You're Tattooing "Do Not Resuscitate" On Your Chest

There's been a lot of press lately about an 80 year old woman who had "do not resuscitate" tattooed on her chest. This is a good idea, but it's too vague, since DNR only applies if a person's heart stops or they stop breathing. To eliminate any ambiguity, the following additional tattoos should also be considered:

"no artificial hydration or nutrition"

"no cardioversion for rapid atrial fibrillation"

"no intubation and mechanical ventilation for potentially reversible conditions"

"no pressors if hypotensive"

"no painful, high risk surgical procedures with a very low likelihood of success"

"...and no dialysis under any circumstances"