Missouri - New TPOPP/POLST Advanced Direct for EMS (Pediatric Focus)-Missouri TPOPP/POLST Form (Pediatric Focus) .pdf slide deck

Pdf Summary

Dr. Chuck Crecelius' presentation focuses on the implementation and benefits of the Transportable Physician Orders for Patient Preferences (TPOPP)/Physician Orders for Life Sustaining Treatments (POLST), which will be fully operational by the end of 2024. The TPOPP/POLST is designed to honor patients' end-of-life wishes more effectively than traditional documents like Missouri's Out of Hospital DNR (OHDNR). TPOPP/POLST covers a broader range of medical decisions beyond just CPR, such as life-sustaining treatments and artificial feeding preferences, making it applicable in various settings from home care to hospitals.<br /><br />The new legislation provides ambulance indemnity, allowing emergency medical services (EMS) to follow TPOPP/POLST forms without fear of legal repercussions, which was previously a limitation in Missouri. TPOPP/POLST can now harmonize with similar forms used in other states like Illinois and Kansas.<br /><br />The TPOPP/POLST document is comprehensive, divided into sections that denote actions during emergencies when a patient is found without a pulse or is still breathing. Each section caters to specific medical procedures, such as CPR, ventilation, and artificial feeding. Furthermore, it details how and who can sign the forms—currently, a physician's signature is mandatory in Missouri, although participation and discussion by other medical staff like NPs and PAs are encouraged.<br /><br />The document underscores the importance of storing TPOPP/POLST copies in easily accessible locations and details procedures for modification or revocation. There is also a strong emphasis on utilizing these forms in pediatric care—recognizing differences in medical decision-making for minors.<br /><br />Dr. Crecelius stresses the need for uniformity in implementing TPOPP/POLST across healthcare facilities and notes the collaborative efforts required among hospitals and nursing homes for successful deployment. The initiative aims to ensure that medical orders are respected and executed consistently regardless of location or situation, particularly in emotionally charged pediatric cases.

Asset Caption

Slide deck from the presentation (Downloadable)

Keywords

TPOPP

POLST

end-of-life

life-sustaining treatments

ambulance indemnity

emergency medical services

Missouri

pediatric care

healthcare facilities

Dr. Chuck Crecelius