What are the differences and similarities between the standard one-page nonhospital DNR order and the MOLST form?
• The MOLST form (DOH-5003) is a bright pink multi-page form; however, a photocopy or facsimile of the original form is acceptable and legal. A Nonhospital Order Not to Resuscitate form (DOH-3474) is a single page form on white paper with black ink. • The MOLST form is meant to be utilized by health care providers across the health care system. It is not limited to EMS agencies; it travels with the patient to different care settings. The Nonhospital Order Not to Resuscitate form is not intended for use in facilities. • MOLST provides for end-of-life orders concerning resuscitation and intubation for Advanced EMTs when the patient is in full cardio-pulmonary arrest or has progressive or impending pulmonary failure without acute cardiopulmonary arrest. The Nonhospital Order Not to Resuscitate form (DOH-3474) only applies to patients in full cardio or pulmonary arrest. • Both forms, the MOLST form and the Nonhospital Order Not to Resuscitate form (DOH-3474) must be authorized and signed b
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