Should family members be present at resuscitation?

Abstract

A 1-year-old boy is brought into Accident & Emergency by paramedics receiving CPR. He has been found pale and unresponsive at home. You take handover from the paramedics and continue the resuscitation. Shortly afterwards, the child’s parents arrive, they are visibly distressed watching the events unfold. You wonder if it is better for the parents to stay and watch or be taken to a quiet room, and if there is any evidence available to support one approach above another? In parents/caregivers of children being resuscitated (population), does observing the resuscitation (intervention) improve the family’s psychological coping and satisfaction with care, and what is the opinion on familial presence from health professionals (outcome)? We searched Ovid Medline on 15 March 2019 using the terms (paediatric OR paediatric OR child) AND (resus* OR CPR OR cardiopulmonary) AND (parent* OR famil*) AND (presence OR witness OR observ*) AND (cop* OR stress). A total of 21 papers were identified. Inclusion criteria were full-text articles with search items identified within the title. Articles were excluded which did not focus on resuscitation, that were not specific to children or their families, were guidelines or opinion pieces. Seven articles were chosen for further review, four were disregarded as they were duplicated within the systematic review. Three papers were therefore included, these were qualitative, reflecting the clinical question asked. These studies are summarised in table 1. View this table: Table 1 Summary of included studies Family-centred care is an important concept within paediatric medicine. The Royal College of Paediatrics and Child Health endorses parents and caregivers to be involved in their children’s care, in order …