Family presence during CPR associated with lower rates of emotional trauma

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1. Family members who were present during CPR suffered from significantly fewer symptoms of PTSD, anxiety, and depression than those who were not present.

2. There were no significant differences in resuscitation outcomes between groups in which family members were present or absent during the resuscitation.

Published today, this study is the first randomized controlled trial to look for benefits in having family members present during CPR. The results are compelling and suggest more favorable emotional outcomes in family members who are present during resuscitation efforts. Neither the resuscitation efforts nor the well-being of the medical team were significantly affected by the presence of family members. The only significant difference between the groups was the apparent emotional well-being of the family members who had been present for the resuscitation efforts. Limitations of the study include the fact that it was performed entirely in France, which has a unique emergency response-team system that includes an ambulance driver, nurse, and a physician who respond directly to the home. It is possible that having a different group of personnel approach family members and perform the resuscitation, or having these efforts occur in a different setting may alter the results. Additionally the intervention in this study was to simply offer for the family member to watch the resuscitation, which may have allowed for self-selection of family members with greater initial emotional stability.

Click to read the study in NEJM

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1. Family members who were present during CPR suffered from significantly fewer symptoms of PTSD, anxiety, and depression than those who were not present.

2. There were no significant differences in resuscitation outcomes between groups in which family members were present or absent during the resuscitation.

This [Randomized controlled] study: investigated the effect of family presence during CPR on both family members and the healthcare team.  The study enrolled patients from multiple pre-hospital emergency service units in France from 2009-2011. These units were randomized to practice their standard procedures regarding CPR (control) or to offer for family members to be present during resuscitation efforts  (intervention). During a cardiac arrest, a member of the response team would systemically ask a specified family member if he/she would like to be present for CPR. 90 days after resuscitation, a psychologist blinded to the study groups evaluated the family members via telephone using standardized scales to assess for symptoms of PTSD, anxiety and depression. Medical teams were evaluated for emotional stress after each resuscitation. Additionally, the authors recorded the events and outcomes of the resuscitation efforts. They found that symptoms of PTSD, depression and anxiety were significantly higher in the family members who had not witnessed the resuscitation compared to those who did. Additionally, there was no significant difference in the outcome of the resuscitation, stress on medical teams or medico-legal conflicts between groups.

In sum: Published today, this is the first randomized controlled trial to look for benefits in having family members present during CPR. The results are compelling and suggest more favorable emotional outcomes in family members who are present during resuscitation efforts. Neither the resuscitation efforts nor the well-being of the medical team were significantly affected by the presence of family members. The only significant difference between the groups was the apparent emotional well-being of the family members who had been present for the resuscitation efforts. Limitations of the study include the fact that it was performed entirely in France, which has a unique emergency response-team system that includes an ambulance driver, nurse, and a physician who respond directly to the home. It is possible that having a different group of personnel approach family members and perform the resuscitation, or having these efforts occur in a different setting may alter the results. Additionally the intervention in this study was to simply offer for the family member to watch the resuscitation, which may have allowed for self-selection of family members with greater initial emotional stability.

Click to read the study in NEJM

By Akira Shishido and Mitalee Patil

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