Families and Resus

[Melclin]

I was wondering about the Journals nerding it up today, and I came across an article in the Journal of Emergency Nursing on families being present at the resuscitation of their loved ones. It argued for the presence of the family at the resus, on the grounds that it's better for a sense of closure and better for letting them see that everything was done.

Someone wrote a letter to the editor in the next issue of the journal saying how right she was to let the family observe the resus and how important she had found it to be for families to be invovled. There is even a recommendation from the Emergency Nurses Association that families should be allowed to observe emergency invasive procedures.

For pre-hospital practitioners, it's pretty normal for the family to be looking over your shoulder during a resus. So how does everyone feel about the idea? Any thoughts, wisdom or, more importantly, studies that you know of regarding the matter?

Now I'm sure this has been discussed in some form throughout the threads, but I couldn't actually see a thread on it. Point away if there's something I missed.

 

[marineman]

I don't have a problem with families standing well out of the way and observing but there are some we have asked to leave the room because they are too upset and distraught and they begin to interfere with care. If they're calm and collected I have no problem, this is out of hospital not sure I would feel the same in hospital simply because there is usually already too many people in the room at the hospital.

 

[Maya]

I'd have to agree. If they are calm or are somehow able to provide assistance if necessary, I wouldn't mind them being there. However, the patient comes first, and if they are being abusive or otherwise interfering with treatment, then they are compromising the EMT/medic's ability to treat the patient, and shouldn't be there.

That said, if the patient were a relative or a friend of mine, I would want to be there. I wouldn't want someone I care about to die alone or with strangers. It's their last few moments alive and you want to be there for them, because you'll never have time with them again.

 

[mmorsepfd]

I actually encourage family to be present during resus attempts.

My friend and co-worker, a Captain on the PFD lost his son on Tuesday. The car accident happened less than a mile from his home. The boy's cell phone landed on a neighbors lawn. He called my friend and told him his son was hurt badly and lying on his lawn.

He arrived before the rescue personnel and started CPR. They let him continue all the way to the trauma room. I talked to him at the wake on Friday, he said the experience is helping him get through this. I can only imagine.

 

[Smash]

Depends on the family and the resus. There is no one size fits all answer. I can't speak for the situation morse had and I'm certainly not going to criticize any decisions made, but in my experience it doesn't always help to have family actively participating in the resus. That is only my experience however.

 

[Maya]

Oh my God, that's horrible. It's every parent's worst nightmare. I'm so sorry to hear that.

 

[mmorsepfd]

Thank you Maya, it must have been horrible. The boy's grandfather was a Rescue Captain in the city where the accident happened, (Warwick, RI) and the family well known and respected by the FD.

It always amazes me how things work; I've been thinking about this nearly non-stop since it happened. I joined this site a few days after the accident and this thread almost magically appears. I kind of feel better already.

 

[Maya]

You guys put your lives on the line for strangers every day. You just never imagine that you would have to outlive your kids, it's heartbreaking. But like you said, he was there for his son when he needed him, before the medics got there. I'm sure that meant a lot to him.

 

[Ridryder911]

I have done intensive research (graduate research) on this topic. I too believe there is much evidence that shows great sucess.

The following must be in place though:

A well developed plan including Chaplain and Social Services
Staff abreast of what to expect and being prepared
Place for family to be (without being in the way)

In my investigation; I could not find any "bad " results reported; except for the staff "feeling " uncomfortable. Many described they felt it made them be more professional and have empathy.

In hospital is much different than in a EMS unit, it is more controlled environment and plenty of professional help is available.

R/r 911

 

[VentMedic]

This has been common in the hospitals for over 20 years, especially for pediatrics.

In the field we often did not have a choice but to allow the families to be present and we made the most of it to be respectful as well as explaining what we could. It often made calling death at the scene a lot easier if they saw we did everything. Family members also appeared less hysterical if they remained than some that were pulled away by other EMS responders to wait anxiously for the unknown or not know what was going on.

This has also been part of the decision when we take a parent in the ambulance or helicopter if the child is unstable. It is a huge responsibility especially if the parent must ride by the pilot. However, in the many years I transported critical children, parents will behave like adults when they are kept informed and rules set sternly.

 

[WuLabsWuTecH]

This has been common in the hospitals for over 20 years, especially for pediatrics.

In the field we often did not have a choice but to allow the families to be present and we made the most of it to be respectful as well as explaining what we could. It often made calling death at the scene a lot easier if they saw we did everything. Family members also appeared less hysterical if they remained than some that were pulled away by other EMS responders to wait anxiously for the unknown or not know what was going on.

This has also been part of the decision when we take a parent in the ambulance or helicopter if the child is unstable. It is a huge responsibility especially if the parent must ride by the pilot. However, in the many years I transported critical children, parents will behave like adults when they are kept informed and rules set sternly.

Vent: we have the same in the Shildrens Hospital here. Yes, the room is crowded already, but we'll have child life, social service, and a chaplin with up to 2 members of the faimly in a corner of the trauma room out of the way. Social Services and Child Life will explain to the family what is happening.

In the ambulance, if we have a critical patient, NO ONE rides. We may make an exception for children and allow one parent in the back but that's a judgment call. Its crowded enough back there already with 3 people (Compressions, Airway, IV and other assessment) so a 4th can really crowd us. On a usual transport, we allow 1 ride up front, and for peds one rider in the back, but for critical pts, we need the space!

I would not feel comfrotable having a parent of a critical child on the chopper. That just seems like an accident waiting to happen. None of the service I know here allow parents on choppers or riders on choppers for that matter associated with the patient.

I have no problem asking PD or FFs to remove people from the scene who are being a hinderance to care.

 

[mmorsepfd]

I try to keep in mind how I would want to be treated if my friend or family member were being treated. Chances are good that time is running out. There won't be a second chance, so my rules are flexible.