Washington Physician Orders For Life Sustaining Treatment (POLST)
At Speedy Template, You can download Washington Physician Orders For Life Sustaining Treatment (POLST) . There are a few ways to find the forms or templates you need. You can choose forms in your state, use search feature to find the related forms. At the end of each page, there is "Download" button for the forms you are looking form if the forms don't display properly on the page, the Word or Excel or PDF files should give you a better reivew of the page.
The Washington Physician Orders for Life Sustaining Treatment (POLST) is provided by Washington State Department of Health.
Physician Ordersfor Life-Sustaining Treatment
FIRST follow these orders, THEN contact physician, nurse practitioner
or PA-C. The POLST is a set of medical orders intended to guide
emergency medical treatment for persons with advanced life limiting
illness based on their current medical condition and goals. Any section
not completed implies full treatment for that section. Everyone shall
be treated with dignity and respect.
Medical Conditions/Patient Goals:
Cardiopulmonary resusCitation (Cpr): Person has no pulse and is not breathing.
mediCal interventions: Person has pulse and/or is breathing.
Use medication by any route, positioning, wound care and other measures
to relieve pain and suﬀering. Use oxygen, oral suction and manual treatment of airway obstruction as
needed for comfort.
Patient prefers no hospital transfer: EMS contact medical control to deter-
mine if transport indicated to provide adequate comfort.
DNAR/Do Not Attempt Resuscitation (Allow Natural Death)
Choosing DNAR will include appropriate comfort measures and may still include the range of
treatments below. When not in cardiopulmonary arrest, go to part B.
Includes care described above. Use medical treatment, IV ﬂuids and
cardiac monitor as indicated. Do not use intubation or mechanical ventilation. May use less invasive air-
way support (e.g. CPAP, BiPAP).
Transferto hospital if indicated. Avoid intensive care if possible.
Includes care described above. Use intubation, advanced airway interventions, mechanical
ventilation, and cardioversion as indicated.
Transferto hospital if indicated. Includes intensive care.
Speedy Template provides all kinds of legal templates, forms and waivers in different editable formats. Use the template search on the top to find the customized templates that fit your needs with absolutely no cost. Those templates are collected online so we do not claim the ownership of those templates. You can think this website as a legal document search portal and use it to find the printable templates and download them to your local computers and make appropriate adjustments from your end. There is no need to create an account or provide your credit card information. Feel free to download those Word, Excel, PowerPoint or PDF files while we continue to improve this website. Hope you can find those free printable templates useful for business or personal purposes.