1. (a) This section, and the Provider Orders for Life Sustaining Treatment (POLST) Program, adopted by reference in 7 AAC 16.020, establish the do-not-resuscitate (DNR) protocol for a health care provider to withhold cardiopulmonary resuscitation under AS 13.52.065. The health care provider implementing the protocol shall comply with applicable state and federal laws and regulations related to the provision of or withholding of care.

2. (b) Unless exempted under (c) of this section, a health care provider must first clearly confirm the identity of a patient by one of the following methods:

   1. (1) the patient communicating the patient's name;
   2. (2) the patient's hospital or other institutional identification arm band;
   3. (3) the patient being personally known to the physician or other health care provider;
   4. (4) the patient's driver's license or credit card;
   5. (5) another person having identified the patient.
3. (c) If a patient is unconscious or otherwise unresponsive to questions regarding the patient's identity, a health care provider may rely solely on the department-approved DNR necklace or bracelet worn by the patient, without using other methods to identify the patient.

4. (d) Once a patient's identity is determined under (b) or (c) of this section, a health care provider shall examine the patient, patient's available medical records, and other sources to determine the patient's DNR status. The patient's DNR status and the patient's desire for resuscitative efforts may be determined using the following:

   1. (1) a department-approved DNR form for the patient;
   2. (2) a department-approved DNR card for the patient;
   3. (3) a department-approved DNR necklace or bracelet worn, or carried, by the patient;
   4. (4) the department's Alaska POLST (Provider Orders for Life Sustaining Treatment) Form, dated January 4, 2024 and adopted by reference;

   5. (5) an attending physician's, attending advanced practice registered nurse's, or attending physician assistant's DNR order, if

      1. (A) the order is in writing and a copy has been provided or seen by the physician or other health care provider; or
      2. (B) a verbal order has been issued directly to a health care provider by the attending physician, attending advanced practice registered nurse, or attending physician assistant;
   6. (6) a DNR, POLST, or MOLST order or identification for the patient that is executed or issued in another state or a territory or possession of the United States and that meets the requirements of AS 13.52.150.
5. (e) A health care provider shall immediately proceed with patient assessment and care, including cardiopulmonary resuscitation, until the information required under (b) - (d) of this section is obtained. Cardiopulmonary resuscitation (CPR) need not be started or continued if the health care provider determines that it would be futile.
6. (f) After establishing that a patient is a qualified DNR patient under AS 13.52 and this chapter, a health care provider may not attempt CPR for a patient who does not have a pulse or is not breathing. The DNR order does not affect other care or services that the health care provider has determined are appropriate for the patient and may lawfully be performed by that provider.
7. (g) A qualified DNR patient, or the patient's attending physician, attending advanced practice registered nurse, or attending physician assistant may revoke the patient's DNR status at any time and in any manner in accordance with AS 13.52.

(Eff. 10/10/96, Register 140; am 5/6/2021, Register 238; am 5/26/2024, Register 250)

Authority: AS 13.52.060, AS 13.52.100, AS 13.52.135, AS 13.52.065, AS 13.52.110, AS 13.52.140, AS 13.52.080, AS 13.52.120, AS 13.52.150, AS 13.52.090, AS 13.52.130, AS 13.52.160