title: Sudden traumatic death in children: "we did everything, but your child didn't survive".
abstract: When caring for children who become suddenly and catastrophically ill, clinicians must simultaneously attend to a complex and rapidly evolving medical situation, as well as to the equally challenging demands of establishing compassionate relationships with family members and communicating well with colleagues. An 18-month-old toddler was brought to the hospital with severe head injury after being struck by a car. Over a period of hours, her condition evolved from prognostic uncertainty to the diagnosis of brain death and considerations of organ donation. Against this medical backdrop, the clinicians successfully established a trusting relationship with family members by careful attention to their emotional, informational, and care needs as they absorbed the devastating prognosis, took in the results of the brain death examination, and considered the option of organ donation. This case illustrates the importance of interdisciplinary communication, the vital role of social workers and other psychosocial providers with expertise in working with families, and the critical significance of mutual care and support for the clinicians who accompany families through these tragic life events.
authors.affiliation: Division of Critical Care Medicine, Children's Hospital Boston, Mass, USA. robert.truog@childrens.harvard.edu
authors.forename: Robert D
authors.initials: RD
authors.lastname: Truog
authors.forename: Grace
authors.initials: G
authors.lastname: Christ
authors.forename: David M
authors.initials: DM
authors.lastname: Browning
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Meyer
mesh_terms: D001926:Brain Death / Q000175:diagnosis*; D003142:Communication; D006259:Craniocerebral Trauma; D003422:Critical Care; D016638:Critical Illness; D005260:Female; D006801:Humans; D007223:Infant; D007400:Interprofessional Relations; D009104:Multiple Trauma; D011368:Professional-Family Relations; D012947:Social Work; D009927:Tissue and Organ Procurement