The Associated Press has reported on the notable increase among the public to no longer use medical ID bracelets, but to instead have medical tattoos.

Use of Tattoos for Medical Information Begins to Grow
EMS personnel face possible AMA guideline change as use of medical tattoos increases.

"The American Medical Association does not specifically address medical tattoos in its guidelines. But Dr. Saleh Aldasouqi, an endocrinologist at Michigan State University, hopes that might change."

"Aldasouqi, who has written about the tattoos, has seen them among his diabetic patients and feels they are becoming so popular that the medical profession needs to help guide their development."

JEMS asks: "If you are faced with a patient that has "No CPR" tattooed on their body, what will your response be?"

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It should prompt a quick discussion with family members on scene while resuscitation is being performed that could lead to cessation of resuscitation efforts, but besides that, no. The problem with DNR tattoos is the inability to easily revoke them.

While I have always joked about having this type of tattoo added to my epidermal canvas, my personal choice of words would be “Do Not Press Here” surrounded by the universal red circle with a line through it. Perhaps with a skull and crossbones added for effect.

But on a serious note (as much as possible for such a dubious question), I have not heard of any state or federal laws being passed since my retirement 5 months ago that identify a tattoo as a medical-legal document. As Joe pointed out, I’m sure that there would be some sort of short conversation with family about the tattoo and the availability of the appropriate, recognized legal documents while I prepared to respond to the situation at hand as I am trained and bound to do.

Really, jems?  Sure let's discuss this, but your question moves the topic beyond the realm of reality at this time.

This certainly doesn't meet the legal requirements of any DNR I'm familiar with.

However, it is a pretty clear expression of patient wishes.

Poses an interesting dilemma.

This is why the guy with MD at the end of his name, at medical control, makes the big bucks!

I actually was in this situation in the ICU where I used to work. The issues the ethics committee addressed were these:

Since there is no evidence that the tattoo was 'witnessed', as a signature on paper would be, how do we verify the validity? (This particular patient was blind, so there's no way to know she even knew what the tattoo said).

Is it possible the patient has changed her mind since getting the tattoo and just hasn't updated it yet?

Since it is not even dated, how can we accept it as binding. It does not meet the standard we demand of any other document.

In the end, the No CPR tattoo was not honored and she did die after being resucitated several times.  

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