EMS & MOLST: 5 Best Practices

Five Things You Can Do Ahead of an Emergency

A MOLST (Medical Orders for Life-Sustaining Treatment) or a CC/DNR (Comfort Care/Do Not Resuscitate) are essential documents in a medical emergency which tell EMS (Emergency Medical Services) your choices for the care you want and do not want. Read more below or download the information as a PDF.

Here are 5 things you can do to help ensure EMS can understand and honor your care choices.

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1. Make sure your medical order is valid!

  • EMS honors 2 types of medical orders: a valid MA MOLST and a valid MA Dept. of Public Health CC/DNR Order Verification Form. They can not honor out of state orders or a local facility’s DNR orders.
  • To be valid, a MA MOLST order must state the adult’s name, and Sections D & Section E (pg.1) must be completely filled-in and legible. Ask the signing clinician to make corrections if needed.
Icon: Handing MOLST to EMS at the door.

2. Make sure it’s visible or “Meet EMS at the door” with a copy.

  • Post your medical order where EMS can see it as soon as they arrive (i.e. on the refrigerator or the back of the front door), OR meet EMS at the door and hand them a copy.
  • If you or a loved one resides in an assisted living, skilled nursing or hospice facility, staff should meet EMS at the front door or at the resident’s room with a copy of the medical order.
  • EMS must have a paper copy of the valid medical order; a verbal assurance that an order exists or is in a file can not be honored.
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3. Make 2 copies for EMS.

  • Copies are as valid as the original order and can be on pink or white paper.
  • Be prepared to give EMS two copies:
    • 1st copy: EMS must keep a copy for their records and to use in transport;
    • 2nd copy: EMS can hand a copy to Emergency Department personnel at the hospital.
Icon of people in a circle: talk to your family

4. Talk with your family ahead about the care you want and do not want.

  • Make a plan with your family. Agree on what to do in an emergency. If families disagree and the patient can not speak for him/herself, EMS can opt to start treatment & transfer to a hospital.
  • Appoint a Health Care Agent in a Health Care Proxy and tell your Agent what you want for care. Keep a copy of your Proxy with your medical order.
  • If you or a loved one resides at an assisted living, skilled nursing or hospice, set up a care planning meeting. Discuss the facilities’ policy & procedures for honoring your medical order.
Icon: 2 people shaking hands. Talk to your doctor.

5. Talk with your doctor or care provider to review & update your medical order.

  • Set up a family meeting with your doctor or health care provider. Discuss your care choices and what to expect during a medical emergency; discuss how family can honor your choices.
  • Keep your medical order up-to-date. Discuss your changing health needs and choices often.

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