Effects of Permitting Family Members to Observe CPR

This is for our followers who practice in the ICU.

Authors: Jabre P et al., Intensive Care Med 2014 May 23;

Grief, post-traumatic stress, and depression at 1 year were reduced when family members were permitted to witness resuscitation of loved ones.

Despite data that suggest benefit to family members from allowing them to observe resuscitations (NEJM JW Emerg Med Mar 15 2013), emergency physicians may be reluctant to do so. In a prospective, cluster-randomized, controlled study involving 15 emergency medical services units in France, researchers compared psychological symptoms at 1 year between family members who were offered the chance to witness an adult resuscitation and those who were not offered the option.

Of 570 family members, 72% were evaluated at 1 year by telephone. Family members in the control group were more likely to experience major depression (31% vs. 23%), complicated grief (36% vs. 21%), and post-traumatic stress disorder-related symptoms (adjusted odds ratio, 1.8).

Comment

Many of us recall the days when fathers were not allowed in delivery rooms for the birth of their child. Death, like birth, is a transformative event for a family. Thoughtful, supportive inclusion of close family members during a resuscitation may not help the patient, but at that moment, isn’t each family member also a patient? Most providers, myself included, who have had family members present during an arrest consider it to have been a positive experience.