In the past, family members have often been excluded from being present during the attempted resuscitation of a child or other relative. Surveys suggest that healthcare providers hold a range of opinions about the presence of family members during resuscitative attempts.1-12 One theoretical concern is the potential for family members to become disruptive, interfere with resuscitative procedures, or develop syncope, and another is the possibility of increased exposure to legal liability; however, these are not reported in the literature.
Several surveys suggested that most family members wish to be present during a resuscitative attempt.5-9 Family members with no medical background have reported that being at a loved one’s side and saying goodbye during the final moments of life was comforting.5,6,10 Family members have also reported that it helped them to adjust to the death of their loved one,11,13 and most indicated that they would do so again.10 Several retrospective reports note positive reactions from family members,1-3 many of whom said that they felt a sense of having helped their loved one and of easing their own grieving.4 Most parents surveyed indicated that they wanted to be offered the option of being present during the resuscitative effort for their child.4,14-22
In the absence of data documenting harm and in light of data suggesting that it may be helpful, offering select family members the opportunity to be present during a resuscitation is reasonable and desirable (assuming that the patient, if an adult, has not raised a prior objection). (Class IIa, LOE C for adults and Class I, LOE B for pediatric patients)
Parents and other family members seldom ask if they can be present unless they are encouraged to do so by healthcare providers. Resuscitation team members should be sensitive to the presence of family members during resuscitative efforts, assigning a team member to remain with the family to answer questions, clarify information, and otherwise offer comfort.9
Notifying family members of the death of a loved one is an important aspect of a resuscitation that should be performed compassionately, with care taken to consider the family‘s culture, religious beliefs and preconceptions surrounding death, and any guilt they may feel associated with the event or circumstances preceding the event.23