Among emergency department patients, 1 in 500 die in transit or in our care.[1] Their last moments are usually marked by intense resuscitation efforts.
Should the family be present during resuscitation? Many physicians – and also some nurses – fear litigation, trauma to onlookers, confusion, and interference in resuscitation. But the data have not supported these fears.[2–13] To the contrary, the evidence indicates that family members' presence may help them understand the severity of the patient's condition and to appreciate their loved one's care. Family presence may allay their guilt, support healthy grieving, and assure them that “everything was done.”[14–18] These features are often amplified if the patient is a child.
Proper training and procedures are required to optimize performance and the experience of family members. Based on what is known in the field, institutions can develop policies and training for staff to make family presence at the bedside, even during the rigors of resuscitation, a valuable experience for all.
That's my opinion. I'm Dr. Tammie Quest, Director of the Education in Palliative and End-of-life Care (EPEC) – Emergency Medicine Project and Associate Professor, Emory University School of Medicine.
For more information, visit www.epec.net/EPEC/Webpages/epecem.cfm
Footnotes
Reader Comments on: Precious Last Moments: Family Presence During Resuscitation See reader comments on this article and provide your own.
Readers are encouraged to respond to the author at TQUEST@emory.edu or to Peter Yellowlees, MD, Deputy Editor of The Medscape Journal of Medicine, for the editor's eyes only or for possible publication as an actual Letter in the Medscape Journal via email: peter.yellowlees@ucdmc.ucdavis.edu
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