Family Presence During CPR- An Update

I'm surprised and excited at the great responses I got to yesterday's post. I appreciate all of the posts that people shared, from EMS providers and civilians as well.

I wanted to share a post from Mary, an old friend and one of my mentors in EMS. She epitomizes the term "black cloud," and is well on her way to becoming one of America's leading emergency physicians, but she was still somehow incapable of managing Blogger's "comment" function. (Just kidding!)

In all seriousness, thank you Mary for sharing this. She brings up an important point- not about whether or not they should be allowed to watch, but about whether we can make it a worthwhile experience by allocating a rescuer to explain the process to the family. I'll also be reposting some of the other responses I got later on.

I will start off with an anecdote of the last code I worked as a physician in the ED. It was one of those scenarios we all dread--where the pt starts off alert and talking to you and then just crumps right in front of you. He was a very pleasant gentleman who had cancer that had metastasized everywhere. However, he still wished for everything to be done, so as his heart rate dropped to zero, we started CPR. We all knew our efforts were in vain, so after we had intubated the pt and the initial craziness of a code being called had worn off, we brought in the family to watch.

As I did compressions, someone else was at the airway bagging the pt, and another doctor explained to the family everything that was going on and encouraged them to go up and hold his hand. After several moments, the son stated, "Look ma, look at his eyes. He's already gone."

With that, the family themselves were the ones who asked for CPR to be stopped and thanked us. It was by far one of the codes I have felt at most peace with because the family themselves were at peace with it and had closure as they realized everything that could be done was being done and they knew that despite our best efforts, their loved one had passed.

So, in short, I echo the previous sentiments that family should be present during a resuscitation, if they wish to be and if they are able to handle it emotionally (i.e. without being a danger or disruption to the staff). With that said, I do recall my previous life as an EMT and I realize that the ED is (relatively) less chaotic than the prehospital environment. It works in the ED because there is always an excess of staff standing around gawking and at least one of these people can actually be put to use speaking to the family. Resources are more limited in the field and there may not always be someone available to ensure the family members' well-being.

I feel like it would be wrong to have family feeling abandoned and alone while witnessing such a brutal and violent event, but if someone is able to talk them through it, I don't see why they shouldn't be allowed to be present, if the provider is comfortable with it.