ABSTRACT
BACKGROUND: The appropriateness of family witnessing resuscitation (FWR) is an ethical dilemma with most emergency care providers being opponents. We hypothesized that patients and their families prefer to witness resuscitation of their loved ones. METHODS: One hundred and fifty patients treated for potential life-threatening conditions in our emergency department were presented with a survey on FWR in the reconvalescence phase. They were asked to give their opinion supposing their situation had worsened, requiring a resuscitation effort. Their closest relatives were asked to complete a related questionnaire. RESULTS: Mean age was 67 years (patient group) and 55 years (relatives group). Fifty-eight percent of the patients were males with only 33% males in the relatives group. Seventy-two percent of the patients preferred the presence of a relative during resuscitation, although 35% estimate that this could be quite a traumatic experience. Forty-one percent had a history of serious medical problems. In the relatives group, 75% expressed their wish to stay with their loved ones and 49% did not fear that this would be too traumatic. There was a good match in patient and family attitude towards FWR (P<0.001). Relatives of a patient with a serious medical history were significantly more in favour of FWR (P<0.01). CONCLUSION: Our study showed that patients and relatives preferred family presence in emergency department during resuscitation, even when the fear of traumatic effects is considered. It will be a great challenge training emergency care providers for this situation. Staff shortages might compromise the essential support of family members in such situations.
Subject(s)
Family Relations , Resuscitation Orders/psychology , Survivors/psychology , Adolescent , Adult , Aged , Aged, 80 and over , Catastrophic Illness/psychology , Emergency Service, Hospital/standards , Female , Humans , Male , Medical Staff, Hospital/psychology , Middle Aged , Prospective Studies , Resuscitation Orders/ethics , Surveys and Questionnaires , Young AdultABSTRACT
OBJECTIVE: To assess the opinion of Belgian Emergency Department (ED) staff regarding family-witnessed resuscitation (FWR). METHODS: All 142 Belgian EDs were sent a questionnaire on hospital-related data and personal questionnaires for the ED staff concerning their opinion on FWR. Opinions of physicians, nurses and other emergency care providers were compared and related with hospital or sociodemographic data. RESULTS: Eighty-five ED services (60%) responded with a total of 1143 personal questionnaires: of these 79% were nurses, and 19% physicians. Eighty percent of the hospitals had a prehospital intervention team. Only two departments (2.5%) practiced structured FWR; 21% put the relatives in the corridor. Eleven percent did not give any information at all to relatives. Fourteen percent organized 'training in coping with relatives'. Forty-one percent of the staff members had been asked for FWR but only 33% were positive about it. Fifty-six percent thought that relatives could be of use in the shock room. Sixty-six percent experienced it as a burden. Sixty-five percent thought that FWR helps in grieving but 93% feared traumatic distress. Sixty-four percent would like to attend the resuscitation of their own relatives. Thirty-five percent fear a high risk of complaints. Prehospital experience, higher workload, seniority and male staff are significant advantages towards FWR. Emergency physicians are more positive towards FWR, nurses less so, followed by other physicians. CONCLUSION: The Belgian ED staff is still unconvinced about FWR. Despite evidence-based data they still think that resuscitation is traumatizing for relatives. Experience, both in as well as out of hospital, is a positive factor.
