DNI Medical Abbreviation
What does DNI mean in medical terms?
What is DNI?
DNI (Do Not Intubate) is a medical directive that instructs healthcare providers not to insert a breathing tube (endotracheal tube) into a patient's airway, even if the patient stops breathing or cannot breathe adequately on their own. This order reflects the patient's advance decision to avoid mechanical ventilation via intubation as a life-sustaining measure. A DNI order is legally and ethically binding and must be documented in the patient's medical record to be honored by the care team.
What DNI Stands For and Where It Comes From
DNI is an abbreviation for "Do Not Intubate." It belongs to a family of medical directives — written orders placed in a patient's chart that guide care decisions in critical or end-of-life situations. Intubation itself refers to the process of inserting a flexible tube through the mouth or nose and into the trachea (windpipe) to keep the airway open and deliver oxygen to the lungs via a mechanical ventilator. The word "intubate" comes from the Latin "in" (into) and "tuba" (tube). When a patient has a DNI order in place, the medical team is instructed to skip this intervention regardless of what happens to the patient's breathing.
DNI orders emerged from the broader advance care planning movement that gained traction in the 1970s and 1980s, as medical technology made it possible to sustain life far longer than patients sometimes wished. The abbreviation itself is now standard across hospitals, nursing facilities, hospice programs, and emergency services in the United States and many other countries.
How DNI Appears in Clinical Practice
In a hospital setting, a DNI order is entered directly into the patient's electronic health record (EHR) and typically flagged so it is visible to every member of the care team — from the attending physician to the overnight nurse to the rapid response team. It often appears prominently on the patient's chart summary, the bedside care board, and in nursing handoff notes. Some facilities use a colored wristband or a specific notation on the patient's door placard to alert all staff at a glance.
A DNI order is frequently documented alongside a DNR (Do Not Resuscitate) order, but the two are not the same thing and a patient can have one without the other. In emergency medicine and critical care, the distinction matters enormously: a patient with a DNI but no DNR may still receive CPR, medications to support blood pressure, supplemental oxygen by mask, or non-invasive breathing support such as a CPAP or BiPAP machine. The only intervention explicitly prohibited by a DNI is the placement of a breathing tube connected to a ventilator.
In skilled nursing facilities and long-term care settings, DNI orders are often part of a broader document called a POLST (Physician Orders for Life-Sustaining Treatment) or MOLST form, depending on the state. These forms translate a patient's wishes into actionable medical orders that travel with the patient across care settings.
What a DNI Order Means for Patients and Families
For a patient, having a DNI order means that if breathing becomes critically impaired, the care team will focus on comfort and alternative support measures rather than mechanical ventilation. This does not mean treatment stops. Clinicians can still provide oxygen through a face mask, medications to reduce breathlessness, sedation for comfort, and any other care that aligns with the patient's goals. What changes is the ceiling of intervention: a breathing tube and ventilator are off the table.
Patients and families should understand that a DNI order is not permanent and can be revoked at any time by the patient if they have decision-making capacity, or by a legally recognized healthcare proxy if the patient cannot speak for themselves. It is also important to know that a DNI does not mean abandonment — it is a directive about a specific technology, not a withdrawal of compassionate medical care.
Anyone considering a DNI order should have a detailed conversation with their physician about what intubation would realistically accomplish given their health condition, what recovery might look like, and what alternatives exist. This conversation is the foundation of informed decision-making.
DNI Compared to DNR and Other Advance Directives
DNI is often confused with DNR (Do Not Resuscitate), but they address different interventions. A DNR prohibits chest compressions and electric shock (defibrillation) used during cardiac arrest. A DNI prohibits placement of a breathing tube. A patient who wants CPR but not intubation would have a DNR order absent but a DNI order present. Conversely, some patients accept intubation for a short, defined trial period but do not want long-term ventilator dependence — this nuance can be captured in time-limited orders or goals-of-care documentation.
Other related abbreviations you may see in a patient's chart include AND (Allow Natural Death), which is a more patient-centered reframing of DNR; DNAR (Do Not Attempt Resuscitation); and POLST, the comprehensive order set that may include DNI and DNR as components. Understanding how these terms relate helps patients and families navigate conversations with their medical team and ensure their wishes are accurately documented and honored across every care setting they encounter.
Questions About DNI
What does DNI mean in medical terms?▾
In medical terms, DNI stands for Do Not Intubate. It is a physician order documented in a patient's medical record that instructs the healthcare team not to insert a breathing tube into the patient's airway, even in an emergency. The order reflects the patient's own decision about the limits of life-sustaining treatment they wish to receive.
What does DNI stand for?▾
DNI stands for Do Not Intubate. The abbreviation is used in hospitals, nursing facilities, hospice programs, and emergency services to communicate a patient's directive against mechanical ventilation via an endotracheal tube. It is one of several standard abbreviations used in advance care planning and end-of-life documentation.
Is a DNI the same as a DNR?▾
No, DNI and DNR are two different orders. DNR (Do Not Resuscitate) prohibits CPR and defibrillation during cardiac arrest, while DNI (Do Not Intubate) prohibits placement of a breathing tube for mechanical ventilation. A patient can have one order without the other, so it is important to clarify with your care team exactly which directives are in place.
Where does a DNI order appear in a patient's chart?▾
A DNI order is entered into the patient's electronic health record and is typically highlighted or flagged so all members of the care team can see it immediately. It may also appear on the bedside care board, in nursing handoff documentation, and on standardized forms like a POLST or MOLST that travel with the patient between care settings. Some hospitals use colored wristbands to alert staff at a glance.
Can a DNI order be changed or reversed?▾
Yes. A DNI order can be revoked at any time by a patient who has the mental capacity to make their own medical decisions. If a patient cannot speak for themselves, a legally designated healthcare proxy or power of attorney for healthcare can request a change. Patients and families should feel empowered to revisit these decisions as health circumstances evolve.
Does a DNI order mean doctors will stop treating the patient?▾
No. A DNI order limits one specific intervention — placement of a breathing tube — but does not stop other forms of medical care. Clinicians can still provide supplemental oxygen by mask, non-invasive breathing support like BiPAP, medications for comfort, IV fluids, pain management, and any treatment consistent with the patient's goals. A DNI is a directive about a specific technology, not a withdrawal of care.
What is the difference between a DNI and a POLST form?▾
A POLST (Physician Orders for Life-Sustaining Treatment) is a comprehensive medical order form that can include a DNI instruction as one of its components. While a DNI is a single directive focused on intubation, a POLST covers a broader range of decisions including CPR, hospitalization preferences, and artificial nutrition. Not all patients have a POLST, but those who do may have their DNI preference incorporated within it.
What should I ask my doctor before agreeing to a DNI order?▾
Ask your doctor what intubation would realistically accomplish given your current health condition and what recovery from mechanical ventilation typically looks like for someone in your situation. It is also worth asking what comfort-focused alternatives are available if you have breathing difficulties, and whether a time-limited trial of ventilation is an option if you are uncertain. These conversations help ensure the decision you make truly reflects your values and goals.