title: Family presence during cardiopulmonary resuscitation.
abstract: BACKGROUND
  The effect of family presence during cardiopulmonary resuscitation (CPR) on the family members themselves and the medical team remains controversial.
  
  
  METHODS
  We enrolled 570 relatives of patients who were in cardiac arrest and were given CPR by 15 prehospital emergency medical service units. The units were randomly assigned either to systematically offer the family member the opportunity to observe CPR (intervention group) or to follow standard practice regarding family presence (control group). The primary end point was the proportion of relatives with post-traumatic stress disorder (PTSD)-related symptoms on day 90. Secondary end points included the presence of anxiety and depression symptoms and the effect of family presence on medical efforts at resuscitation, the well-being of the health care team, and the occurrence of medicolegal claims.
  
  
  RESULTS
  In the intervention group, 211 of 266 relatives (79%) witnessed CPR, as compared with 131 of 304 relatives (43%) in the control group. In the intention-to-treat analysis, the frequency of PTSD-related symptoms was significantly higher in the control group than in the intervention group (adjusted odds ratio, 1.7; 95% confidence interval [CI], 1.2 to 2.5; P=0.004) and among family members who did not witness CPR than among those who did (adjusted odds ratio, 1.6; 95% CI, 1.1 to 2.5; P=0.02). Relatives who did not witness CPR had symptoms of anxiety and depression more frequently than those who did witness CPR. Family-witnessed CPR did not affect resuscitation characteristics, patient survival, or the level of emotional stress in the medical team and did not result in medicolegal claims.
  
  
  CONCLUSIONS
  Family presence during CPR was associated with positive results on psychological variables and did not interfere with medical efforts, increase stress in the health care team, or result in medicolegal conflicts. (Funded by Programme Hospitalier de Recherche Clinique 2008 of the French Ministry of Health; ClinicalTrials.gov number, NCT01009606.).
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), Service d'Aide Médicale d'Urgence (SAMU), Hôpital Avicenne, Bobigny, France.
authors.forename: Patricia
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authors.lastname: Jabre
authors.forename: Vanessa
authors.initials: V
authors.lastname: Belpomme
authors.forename: Elie
authors.initials: E
authors.lastname: Azoulay
authors.forename: Line
authors.initials: L
authors.lastname: Jacob
authors.forename: Lionel
authors.initials: L
authors.lastname: Bertrand
authors.forename: Frederic
authors.initials: F
authors.lastname: Lapostolle
authors.forename: Karim
authors.initials: K
authors.lastname: Tazarourte
authors.forename: Guillem
authors.initials: G
authors.lastname: Bouilleau
authors.forename: Virginie
authors.initials: V
authors.lastname: Pinaud
authors.forename: Claire
authors.initials: C
authors.lastname: Broche
authors.forename: Domitille
authors.initials: D
authors.lastname: Normand
authors.forename: Thierry
authors.initials: T
authors.lastname: Baubet
authors.forename: Agnes
authors.initials: A
authors.lastname: Ricard-Hibon
authors.forename: Jacques
authors.initials: J
authors.lastname: Istria
authors.forename: Alexandra
authors.initials: A
authors.lastname: Beltramini
authors.forename: Armelle
authors.initials: A
authors.lastname: Alheritiere
authors.forename: Nathalie
authors.initials: N
authors.lastname: Assez
authors.forename: Lionel
authors.initials: L
authors.lastname: Nace
authors.forename: Benoit
authors.initials: B
authors.lastname: Vivien
authors.forename: Laurent
authors.initials: L
authors.lastname: Turi
authors.forename: Stephane
authors.initials: S
authors.lastname: Launay
authors.forename: Michel
authors.initials: M
authors.lastname: Desmaizieres
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Borron
authors.forename: Eric
authors.initials: E
authors.lastname: Vicaut
authors.forename: Frederic
authors.initials: F
authors.lastname: Adnet
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology; D016887:Cardiopulmonary Resuscitation / Q000523:psychology*; D015897:Comorbidity; D003863:Depression / Q000209:etiology; D004632:Emergency Medical Services; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*