DNI -- A Do Not Intubate (DNI) order

A Do Not Intubate (DNI) order is an actionable, legal medical directive instructing healthcare providers not to insert a breathing tube (endotracheal tube) into the trachea

or place the patient on a mechanical ventilator if they stop breathing. It is a specific, limited instruction often part of a broader advance directive or DNR/DNI/AND - CureSearch for Children's Cancer. 

Key Aspects of DNI Orders:

• Definition: Unlike Do-Not-Resuscitate (DNR) - Cleveland Clinic, which prohibits CPR, a DNI allows other interventions like chest compressions, medications, or defibrillation, but specifically restricts the use of an invasive ventilator.
• Usage: These orders are typically used for patients with terminal illnesses, severe chronic conditions, or as part of a comprehensive end-of-life plan to avoid life-prolonging, invasive, or uncomfortable procedures.
• Medical Context: A DNI order signifies a decision against invasive mechanical ventilation, but may still allow for non-invasive ventilation (NIV) like BiPAP, which can be effective in some cases, particularly for COPD or pulmonary edema.
• Consent & Ethics: DNI orders are part of informed consent and advance care planning, allowing patients to control their care. They are often accompanied by, or associated with, Do-not-resuscitate (DNR) - PMC - NIH. 

DNI vs. DNR:

• DNI: Specifically means "Do Not Intubate." No breathing tube.
• DNR: Specifically means "Do Not Resuscitate." No CPR.
• A patient may have a DNI order, a DNR order, or both (DNR/DNI).