Protocole De Communication Avec La Famille Durant Et Apres La Reanimation Cardio-Pulmonaire

WEB TABLE: Guidelines for family presence during resusCitation

Family support during the resuscitation

Prior to family member entry

Before allowing the family member to enter the room where cardiopulmonary resuscitation (CPR) was taking place, the family support assistant explicitly described the appearance of the patient (nudity, skin color, etc.), the treatments administered (medication injections, artificial respiration and tracheal intubation, electrical countershock, etc.).

The assistant further explained that the patient’s care took priority, that only a reasonable number of family members would be permitted to observe, and that the family member would have the option to leave the room at any time.

The family support assistant ascertained that the most invasive maneuvers (intubation and venous line placement) had already been accomplished.

Upon family member’s entry

Upon entry of the family member, the assistant chose a place compatible with CPR with minimal interference.

The assistant:

o Introduced the team

o Explained what was happening during the resuscitation

o Translated any medical terms used

o Informed the family member of the evolution of the patient during the process

o Comforted the family member

o Entertained any questions the family member might have

If the family member presented behavioral issues (malaise, aggressiveness, agitation), the assistant accompanied him/her out of the room and attended to his/her needs.

At the termination of CPR, the assistant directed the family member outside and placed him/her in a comfortable location for debriefing.

Interview after CPR

This interview was conducted by the physician, who was expected to:

§ Inform the family member of the death in empathic terms (I’m very sorry for your suffering, etc.)

§ Explain once again the resuscitative procedures

§ Emphasize that «everything that could be done was done for the patient.»

§ Offer the family member the option of spending a few moments with the deceased

§ Attempt to relieve the family member of any sense of remorse or responsibility where it existed

§ Explain possible grief reactions accompanying death (emotional paralysis, anger, sadness, helplessness, sense of abandonment, etc.)

§ Inform the family member about funeral and administrative proceedings (contacting the funeral home, obtaining a death certificate, possible obstacles)

§ Call, if necessary, the treating physician or the SAMU

§ Offer the possibility of specialty consultation related to grieving (psychiatrist, psychologist)

§ Solicit questions on the part of the family member

§ Solicit the feelings of the family member

§ Express the compassion of the healthcare team for the sadness incurred by the loss of the family member

§ Mobilize other members of the family