Offering the opportunity for family to be present during cardiopulmonary resuscitation: 1-year assessment.
OBJECTIVE
To evaluate the psychological consequences among family members given the option to be present during the CPR of a relative, compared with those not routinely offered the option.


METHODS
Prospective, cluster-randomized, controlled trial involving 15 prehospital emergency medical services units in France, comparing systematic offer for a relative to witness CPR with the traditional practice among 570 family members. Main outcome measure was 1-year assessment included proportion suffering post-traumatic stress disorder (PTSD), anxiety and depression symptoms, and/or complicated grief.


RESULTS
Among the 570 family members [intention to treat (ITT) population], 408 (72%) were evaluated at 1 year. In the ITT population (N = 570), family members had PTSD-related symptoms significantly more frequently in the control group than in the intervention group [adjusted odds ratio, 1.8; 95% confidence interval (CI) 1.1-3.0; P = 0.02] as did family members to whom physicians did not propose witnessing CPR [adjusted odds ratio, 1.7; 95% CI 1.1-2.6; P = 0.02]. In the observed cases population (N = 408), the proportion of family members experiencing a major depressive episode was significantly higher in the control group (31 vs. 23%; P = 0.02) and among family members to whom physicians did not propose the opportunity to witness CPR (31 vs. 24%; P = 0.03). The presence of complicated grief was significantly greater in the control group (36 vs. 21%; P = 0.005) and among family members to whom physicians did not propose the opportunity to witness resuscitation (37 vs. 23%; P = 0.003).


CONCLUSIONS
At 1 year after the event, psychological benefits persist for those family members offered the possibility to witness the CPR of a relative in cardiac arrest.
AP-HP, Urgences-Samu 93, Hôpital Avicenne, Université Paris 13, 93000, Bobigny, France.
Patricia
P
Jabre
Karim
K
Tazarourte
Elie
E
Azoulay
Stephen W
SW
Borron
Vanessa
V
Belpomme
Line
L
Jacob
Lionel
L
Bertrand
Frederic
F
Lapostolle
Xavier
X
Combes
Michel
M
Galinski
Virginie
V
Pinaud
Carla
C
Destefano
Domitille
D
Normand
Alexandra
A
Beltramini
Nathalie
N
Assez
Benoit
B
Vivien
Eric
E
Vicaut
Frederic
F
Adnet
D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D016887:Cardiopulmonary Resuscitation / Q000523:psychology*; D003863:Depression / Q000453:epidemiology; D004632:Emergency Medical Services; D005190:Family / Q000523:psychology*; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006117:Grief; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D057194:Intention to Treat Analysis; D011446:Prospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology