|
Author |
Bryson Galozo |
Date |
2020-12-29 |
|
Reviewer |
Jennie Helmer |
Edited |
2020-12-29 |
You and your partner arrive to a witnessed cardiac arrest. You initiate Cardiopulmonary Resuscitation (CPR) and attach the defibrillator pads. As more responders arrive, you go to the other room to speak with the family. You think about offering the family a chance to watch the resuscitation. You wonder if allowing the family to watch the resuscitation would help or harm their long-term psychological wellbeing.
“For family members of patients in cardiac arrest, how does being present during CPR compare to not being present during CPR, in terms of psychological benefits (or harms)?
|
Population |
Family members of patients in cardiac arrest |
|
Intervention |
Being present during CPR |
|
Comparison |
Not being present during CPR |
|
Outcome |
Family member psychological outcomes |
PubMed: (CPR OR “Cardiopulmonary Resuscitation”) AND (Family OR Relative) AND (Present OR Presence OR Witness) AND (PTSD OR "Posttraumatic Stress Disorder" OR "Psychological Outcomes" OR "Psychological Effects")
20 Results (5 Relevant) on 2020-12-29
In the case of cardiac arrest, there is often concern not only for the patient in cardiac arrest, but also for the family and friends who are present. Family and friends of a person in cardiac arrest are often considered patients that require some form of treatment by providers. Treatment may involve emotional support or connecting family members with victim services.
It is important to consider how to conduct a resuscitation that maximizes beneficial outcomes for everybody present during a cardiac arrest event. One consideration is whether or not to invite or discourage the family from watching the resuscitation. A 2017 survey found that many clinicians are reluctant to invite families to watch a resuscitation due to concerns over Post Traumatic Stress Disorder (PTSD) or potential interference with the resuscitation (Blanco 2017).
Five relevant papers were found. Two small observational studies found either no psychological difference for family-members witnessing versus not witnessing resuscitation (Compton et al. 2009) or a non-significant increase in PTSD-like symptoms for family members who witness a resuscitation (Compton et al, 2011). A larger prospective experimental study demonstrated a statistically significant reduction of PTSD-like symptoms and psychological disorders for family members invited to watch the resuscitation of their family member in cardiac arrest (Jabre et al. 2013). This finding was found to be long-term when the authors revisited study-subjects one-year later (Jabre et al. 2014). Finally, in their quasi-experimental study, Soleimanpour et al. found that when family members are present during an arrest, explanation of the resuscitation process was associated with better psychological outcomes than merely witnessing the process (2017).
The strongest evidence suggests that inviting family-members to witness the resuscitation of a patient in cardiac arrest is associated with positive psychological outcomes and a reduction of depression and/or symptoms of PTSD. Paramedics should actively offer families a chance to watch the resuscitation (assuming there is no interference) and should explain the process if possible.