What is POLST?
POLST stands for Physician’s Order for Life Sustaining Treatment.
A POLST Paradigm form is a brightly colored, medical order form, used to write orders indicating life-sustaining treatment wishes for seriously ill patients. It addresses two needs. It turns treatment wishes of an individual (something you might find on an advanced directive) into actionable medical orders for emergency responders, and then makes it portable.
It solves the problem that EMS generally can’t act on medical wishes for withholding treatment unless a doctor is involved. The POLST document is signed by the patient and their doctor in advance of the possibility of the arrival of emergency care. It doesn’t take the place of an advanced directive because it’s only used in very specific situations. There’s a great FAQ from the Oregon site and a Word document from the Washington State Aging & Disability Services Administration.
The Oregon POLST covers the following areas:
- Cardiopulmonary Resuscitation (CPR) vs Do Not Resuscitate (DNR)
- Medical Interventions
- Antibiotics
- Artificially Administered Nutrition
It’s not available for use in every state, though there are efforts in many states to adopt the POLST Paradigm. You can see which states honor them on the POLST site. As of September, 2008 there were about nine states that honor a POLST.
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