Mary Rose E.

Linatoc
MSN II

Seeing CPR done on loved

one, even if fails, may
help coping
"Family presence during CPR was
associated with positive results on
psychological variables and did not interfere
with medical efforts," wrote the team, led by
Patricia Jabre of Avicenne Hospital in
Bobigny.
CPR is unsuccessful in the vast
majority of cases, and supporters of the idea
of allowing family members to observe say
it can help them understand that medical
workers did everything the could, come to
grips with the reality of death and give the
family the chance to say goodbye.
"Our results show that it is very
important to systematically propose to the
relative (it's not mandatory) that the relative
attend CPR and offer the choice to be
present or not," said study author Frederic
Adnet, also of Avicenne Hospital, told
Reuters Health in an email.
The French group's conclusions were
based on 570 cases treated by 15 emergency
medical teams equipped with mobile
intensive care units and staffed with at least
one
doctor
and
nurse. In each case when watching was
permitted, family members were directly
asked if they wanted to observe. If not, they
were taken to another part of the home.

When people chose to watch, a

member of the team briefed the relatives
through the process. Ninety days later,
relatives were interviewed using a 15-item
questionnaire.
Among the 266 cases in which
family were asked if they wanted to watch,
somebody chose to do so 79 percent of the
time. In the 304 cases where no special
effort was made to ask and the usual practice
was in place, 43 percent of the time
somebody chose to watch.
Of the 570 people who had CPR,
only 20 were still alive 28 days later, a
survival rate of 4 percent. Whether family
members were allowed to watch made no
difference in that rate.
Among the families who did not
witness the CPR, the rate of post-traumatic
stress disorder (PTSD) symptoms was 60
percent higher than among the relatives who
watched.
While 12 percent of the people who
didn't witness the CPR said they wished they
had, only 3 percent of the relatives who
watched said they wished they hadn't been.
U.S. researchers noted that most U.S.
rescue units don't have somebody designated
to explain CPR to the family, and the
emphasis is often on quickly stabilizing
them
enough
to
get
to
a
hospital, which may hamper interaction with
the family.
http://articles.chicagotribune.com/2013-0313/news/sns-rt-health-cprcopingl3n0c607320130313_1_cpr-comilla-sasson-posttraumatic-stress

Reaction:
Based on my experience, with a relative present, there is a pressure for the trauma
team to perform well. This may be inhibited by a reluctance to discuss the patients
condition in front of the relative. "We felt unable to voice our opinion about the patients
deteriorating condition. But in the part of the patients relative seeing what is happening
to their loved one, even for a short period of time, may help to dispel terrible imagery or
anxiety. "Relatives can see that everything possible is being done for their loved one".
According to Robinson et al (1998) conducted a small study into whether relatives
wished to be present during resuscitation, and if so, were there adverse psychological side
effects (9). The study involved relatives of 25 patients (including trauma victims) and
was completed earlier than expected as the staff could see the benefits of having relatives
present. Findings included:
No relatives commented on any technical procedures - problems (including a
difficult intubation)
All relatives felt that it had been beneficial to be present
Trends towards lower degrees of intrusive imagery, post traumatic stress disorder,
and grief related symptoms
Staff viewed the patient as a valued family member
In their conclusion, the authors noted that there was little evidence to support the
exclusion of relatives who wished to be present during resuscitation.