Witnessed resuscitation: A comparison of the preferences and views between survivors of resuscitation and hospitalised patients without this experience
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文摘
In this pilot study, relatives of patients who required resuscitation were given the option to remain with the patient during resuscitation or were not given this choice and directed to the relatives' room (control group). The unit of randomisation was the patient who required resuscitation and not the relatives. One close relative was paired with each patient. All relatives were accompanied by a chaperone who gave emotional support and provided technical information on the resuscitation. Relatives were followed up 1 month after the resuscitation. We used a questionnaire to ask about the decision to be present or absent during resuscitation. Bereaved relatives also completed five standardised psychological questionnaires to assess anxiety, depression, grief, intrusive imagery, and avoidance behaviour.

Findings

25 patients underwent resuscitation (13 in witnessed resuscitation group, 12 in control group). Three patients in the witnessed group survived, all the control-group patients died. Two relatives in each group were lost to follow-up. Thus, eight relatives who witnessed resuscitation and ten control-group relatives were followed up. There were no reported adverse psychological effects among the relatives who witnessed resuscitation, all of whom were satisfied with their decision to remain with the patient. The clinical team became convinced of the benefits to relatives of allowing them to witness resuscitation if they wished, so the trial was terminated.

Interpretation

In the context of the emergency department, routine exclusion of relatives from the resuscitation room may no longer be appropriate.


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The relationship between the hospital setting and perce...
Resuscitation
The relationship between the hospital setting and perceptions of family-witnessed resuscitation in the emergency department
Resuscitation, Volume 70, Issue 1, July 2006, Pages 74-79
Cheryl Macy, Emily Lampe, Brian O’Neil, Robert Swor, Robert Zalenski, Scott Compton

Abstract

Summary

Objective

To compare the support for, and perceptions of, family-witnessed resuscitation (FWR) in urban and suburban emergency departments (ED).

Methods

A convenience sample of ED personnel from two urban and two suburban midwestern hospitals in the United States were surveyed. Survey questions assessed respondents’ opinions and experiences regarding the presence of family members during a resuscitation attempt. Data analysis was conducted using descriptive statistics, 95 % confidence intervals (CI), and χ2 tests.

Results

There were 218 respondents to the survey (108 urban, 110 suburban) of which the majority (63.3 % ) were female, and a mean (S.D.) age of 36.9 (10.2). The majority [131 (60.1 % )] were health care providers (i.e. physicians, nurses, and physician assistants) while the remainder included support staff (i.e. security, pastoral care, and social workers). Half (50.9 % ; 95 % CI: 44.3–57.6) of all ED personnel felt it was appropriate for an escorted family member to be allowed to be present during a resuscitation attempt. However, ED personnel of urban settings were less likely to support FWR (38.9 % urban versus 62.7 % suburban; p < 0.001). Likewise, fewer urban than suburban personnel thought that the psychological impact of witnessing a failed resuscitation attempt would be beneficial for a family member (37.6 % versus 61.7 % ; respectively, p = 0.001). Of note, a minority, yet substantial percentage of all ED personnel believed that the practice would increase the potential for malpractice litigation (28.7 % urban versus 21.8 % suburban; p = 0.242).

Conclusion

Overall, there is divided support among ED personnel for FWR. The hospital setting appears to influence this support strongly, as well as the perceived benefit of FWR.


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doi:10.1016/j.resuscitation.2008.03.086
Copyright © 2008 Published by Elsevier Ireland Ltd.

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Witnessed resuscitation: A comparison of the preferences and views between survivors of resuscitation and hospitalised patients without this experience

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