Can Paramedics and Doctors Honor Medical Tattoos?

A DNR tattoo may not be as effective as you think

Giving a tattoo
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There's a growing trend of tattoos that are intended to replace the use of medical jewelry in emergency situations. It might be on your wrist, stating that you have an allergy or a medical condition. It's also common to find a "D.N.R." tattoo, meaning that someone does not wish to be resuscitated. These are typically on the chest with the intention of being easy to find before administering CPR.

Before you decide to permanently commit to a tattoo for emergency medical notification, ask yourself, "Will the paramedics or doctors follow my wishes or even notice the tattoo?"

Tattoos vs. Jewelry

Paramedics and EMTs are familiar with medical jewelry. MedicAlert pioneered the idea in 1953 and many other companies have followed suit. It doesn't stop with jewelry. New technology like USB flash drives and RFID tags have been marketed for this purpose as well.

Medical jewelry is quite popular and a good idea if you have any sort of medical diagnosis that is important for emergency personnel to know about. However, tattoos are something that medical personnel may not notice, especially if you have multiple tattoos.

The advantage to tattoos over jewelry is that it cannot get lost. If you are in a car accident, a bracelet or necklace can be separated from your body. If you're unconscious, you will not be able to tell a paramedic that you're allergic to bee stings or are taking blood thinners, for instance. A tattoo, on the other hand, is always there, but it needs to be easily visible to paramedics to be effective.

Whether it's medical jewelry or a tattoo, a paramedic may not notice either. In an emergency situation, paramedics are trained to treat the patient based on the signs and symptoms of the medical condition. They may not have the time to look at or search for something about your medical history. 

The Confusion of DNR Tattoos

Tattoos stating "Do Not Resuscitate" are commonly abbreviated D.N.R.

and located on the chest. These are a different story than medical alert tattoos. In this case, the tattoo is often highly visible to anyone who might be giving you CPR, but they are not necessarily legally binding. 

The first problem lies in the fact that do not resuscitate (DNR) orders have certain rules that make them valid. It varies by state, but in general, a DNR must be signed by a doctor. Typically, this involves having a legal document on you or on file which medical professionals can refer to. A DNR tattoo does not have this formality. Also, if you decide to, a DNR order can be rescinded.

A tattoo, on the other hand, is permanent. If you change your mind about being resuscitated, it will cost you far more than the tattoo to have it removed. Many people choose to leave them rather than pay for removal, even after changing their minds.

In some cases, people have even received the DNR tattoo on a dare or while inebriated. It's a decision that they later regret. One man in this situation said that he didn't think his DNR tattoo would be taken seriously. In this case, he had updated his formal directive on file to indicate that he did want to receive CPR, except when it would be a prolonged attempt.

When he was admitted to the hospital for a surgical procedure, he was able to explain the situation.

In another case, a 70-year-old man with a number of medical conditions had "Do No Resuscitate" along with what appeared to be his signature tattooed on his chest. When he was admitted into the ICU, he was unconscious and unidentified, so doctors had no one to speak to about his care.

This caused confusion and moral questions among the medical staff who were not going to honor the tattoo at first. The hospital's ethics consultants thought it should be honored because the law is not entirely clear on the matter.

Eventually, they were able to locate the patient's official DNR order. He later passed away with no attempt at CPR.

There is also the possibility that a DNR tattoo doesn't actually stand for "Do Not Resuscitate." It could be the initials of a person's name or some other meaningful phrase. Tattoos are often very personal and medical professionals may be uncertain about how to interpret them.

Even beyond the fact that they are not bound legally to honor a DNR tattoo, you can see the potential for confusion in these situations. This is why medical professionals may try to perform CPR if you go into cardiac arrest, even if you have a tattoo.

A Word From Verywell

It's always important to think long and hard before getting any tattoo and those with medical directives are no exception. As you can see, it is not a sure way to tell paramedics and doctors about your medical history or wishes.

This is especially true with the DNR tattoos because there is too much grey area. In an emergency, their job is to save your life and this tattoo leaves many questions unanswered. If you wish to not receive CPR, file a formal DNR order with the proper authority in your area.

Source:

Cooper L, Aronowitz P. DNR Tattoos: A Cautionary Tale. Journal of General Internal Medicine. 2012;27(10):1383. doi: 10.1007/s11606-012-2059-8.

Holt GE, Sarmento B, Kett D, Goodman KW. An Unconscious Patient With a DNR Tattoo. The New Englan Journal of Medicine. 2017;377:2192–2193. doi: 10.1056/NEJMc1713344.

Smith AK, Lo B. The Problem With Actually Tattooing DNR Across Your Chest. Journal of General Internal Medicine. 2012;27(10):1238-1239. doi: 10.1007/s11606-012-2134-1.

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