Archives for March 26, 2004

Family Seeing Codes

Cut To Cure has an interesting after-action on his CME trip to Vegas. The part that caught my attention was:

On the last day, half of the morning was spent on discussions of “ethical issues” the most interesting one was related to the presence of family members in the trauma bay during resuscitation. Objections included the lack of space in the ED, having family members “fall out” during a resuscitation, family member interference and criticism (that’s not how Dr. Carter did it on ER last night!) and of course, fear of litigation if things don’t go well. Those that support the presence of family members during resuscitation cite reports (mainly related to ICU codes) that state the emotional benefits and “closure” that having family members present provides. The speaker polled the audience asking who would want their family member to see them with all of the accessories that go along with a complicated trauma resuscitation, very few said yes. I think that the presence of families in the trauma bay can only be a hindrance.

I do resuscitations for a living, and can say that only in VERY limited circumstances would I NOT allow a family into the room. (One or two, not the extended family).

There is, when present, no doubt in their mind that everyone is doing everything to “save” their loved one. I would say that the family of the chronically ill “do the best”, as they’ve been around medicine and hospitals for a long time, and the environment isn’t overwhelming. Those who aren’t hospital aware are frequently comforted by the fact that all those people are working so, hard, which is the absolute truth.

I support letting the family in. If they’re disruptive, let them go (with the Chaplain, or your equivalent), but most will understand. It’s what I’d want. I wouldn’t insist reluctant observers be forced to attend, but were it me, and my family is on the table, I want to be there.

I’m a control freak, and it’s very hard for me to let go, but this is one time when letting go of control, and letting in the family, is the best for all concerned.