• Should families be present for CPR?

    I’m sure you’ve all seen a TV show or movie where a patient has gone into cardiac arrest, and as the medical team begins resuscitation, the family is hustled away. This happens in the real world, too. Some believe that it’s a bad idea for families to watch something so stressful. Others believe that having family members present could distract medical personnel from what they’re doing. The rest believe that letting families remain puts them at legal risk.

    In almost every case I can remember, though, families didn’t want to leave. Should we make them? If only there was a study! “Family Presence during Cardiopulmonary Resuscitation“:

    BACKGROUND: The effect of family presence during cardiopulmonary resuscitation (CPR) on the family members themselves and the medical team remains controversial.

    METHODS: We enrolled 570 relatives of patients who were in cardiac arrest and were given CPR by 15 prehospital emergency medical service units. The units were randomly assigned either to systematically offer the family member the opportunity to observe CPR (intervention group) or to follow standard practice regarding family presence (control group). The primary end point was the proportion of relatives with post-traumatic stress disorder (PTSD)–related symptoms on day 90. Secondary end points included the presence of anxiety and depression symptoms and the effect of family presence on medical efforts at resuscitation, the well-being of the health care team, and the occurrence of medicolegal claims.

    What did they find? Most of the relatives in the intervention group (79%) watched CPR, compared to only 43% in the control group. Surprisingly, PTSD-related symptoms were significantly more common in the control group than in the intervention group, as well as more common in family members who did not witness CPR than in who did. Family members who witnessed CPR had symptoms of anxiety and depression less frequently than those who did not.

    Moreover, family-witnessed CPR had no effect on the processes of resuscitation, stress felt by the medical team, whether the patient survived, or on the likelihood of a lawsuit.

    In summary, watching CPR was good for relatives of patients (unexpected), didn’t distract the medical team (unexpected), and didn’t lead to lawsuits (unexpected).

    This is why we do research.

    @aaronecarroll

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    • I’d suspect that not knowing what is happening is stressful too, so seeing that the medical personnel are doing everything they can to revive your loved one might be less, not more, stressful than sitting in a waiting room now having any clue what’s happening.

    • As long as family members do not interfere with the resuscitation, there is a lot of benefit to having the family in the room. They clearly understand the measures that are being taken for their loved ones. It also provides a sense of closure for the family and makes the resuscitation more concrete to the family. I’m in favor of it.