In the presence of a valid, documented DNR order, providers should **not** initiate CPR on a client when the DNR prohibits resuscitation. Staff should:

1. Call 911 and remain with the client.
2. Notify a supervisor immediately.
3. Present the DNR order to emergency medical responders upon their arrival.
4. Provide comfort care and keep the client calm and comfortable.
5. Document the event in detail.

For clients **without** a DNR on file, providers are generally expected to initiate CPR if a client is unresponsive and not breathing, pending arrival of emergency services. Arkansas DHS/DDS licensing requirements for most ADDT programs require that a designated number of staff maintain current CPR and First Aid certification at all times during program hours.

Providers should:
– Ensure all staff clearly know which clients have DNRs (this is a critical safety briefing).
– Include DNR procedures in your emergency response protocols.
– Consult with legal counsel and your DDS licensing specialist to confirm your specific obligations, as requirements can vary by program type and client population.