ניהול מלר"ד - האיגוד הישראלי לרפואה דחופה

PODCAST: Family Presence during Resuscitation

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Show Notes
Overview
  • Historical Context: The conversation around allowing family members in the room during resuscitation events began gaining attention in 1987. Since then, the practice has been increasingly encouraged.
  • Current Practices in Pediatrics:
    • Family presence during pediatric resuscitations remains inconsistent, with healthcare provider acceptance ranging from 15% to 85%.
    • Many subspecialists and consultants still request that families step out, often due to outdated concerns.
    • Common Concerns & Myths:
      • Interference in resuscitation → Studies show minimal disruption.
      • Legal risks → No increased litigation risk has been demonstrated.
      • Family trauma → Research suggests that presence may help with grieving and reduce PTSD symptoms.
        • Evidence from the Literature

        New England Journal of Medicine study on Family Presence During Cardiopulmonary Resuscitation (Jabre et al., 2013):

        • In a randomized controlled trial of 570 relatives, PTSD-related symptoms were significantly higher in family members who were not offered the opportunity to be present during resuscitation.
          • 79% of relatives in the intervention group witnessed CPR compared to 43% in the control group.
          • Family members who did not witness CPR had a higher likelihood of PTSD symptoms (adjusted OR 1.7, p=0.004).
          • Anxiety and depression symptoms were also higher in those who did not witness CPR.
          • Impact on Medical Teams:
            • The study found no evidence that family presence affected resuscitation success rates, medical team stress levels, or led to legal consequences.
            • Health professionals’ concerns over interference were largely unfounded.
              • Guideline Support & Barriers to Implementation
              • Professional recommendations from pediatric societies support family presence during resuscitations.
              • Barriers include:
                • Lack of institutional policies ensuring family inclusion.
                • Lack of formal training for providers on how to support families during these critical moments.
                  • Final Takeaways
                  • Encouraging institutional policy changes and training providers is key to implementing family presence during codes.
                  • Medical teams should challenge outdated practices and prioritize family-centered care in the emergency department.
                  • Family-witnessed resuscitation does not increase stress, legal risk, or compromise medical care—but it can significantly improve bereavement outcomes.

                    • The post PODCAST: Family Presence during Resuscitation first appeared on האיגוד הישראלי לרפואה דחופה.

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