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As such, another proposed mechanism for the decrease in cardiac arrest rates associated with RRTs is increased use of palliative care services and DNAR orders for patients who are dying and for whom resuscitation attempts are likely to be futile or inconsistent with their goals of care. Once a patient has a cardiac arrest, institution of a DNAR order to prevent further resuscitation attempts is frequently entertained. However, many of these patients may have been appropriate for consideration of such an order before the arrest, and failure to properly consider it could result in an unwanted aggressive end to life and a waste of considerable resources. As such, it is consistent with a system of care to seek patient or family preferences regarding aggressive resuscitation measures, such as CPR and mechanical ventilation, in patients with advanced age or terminal condition and short life expectancy who are admitted to a hospital, and to issue a DNAR order based on patient or family preference as well as expectation of outcome, taking into account the clinical judgment of experienced providers. Tacloban Mayor Alfred Romualdez urged residents to flee the city because local authorities were having trouble providing food and water and maintaining order, The New York Times reported. He said the city desperately needed trucks to distribute relief shipments accumulating at the airport as well as equipment to pull decaying corpses from the rubble.
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