References

Family presence during resuscitation: an evaluation of attitudes and beliefs. 2016. https//uknowledge.uky.edu/dnp_etds/99/ (accessed 5 December 2023)

Afzali Rubin M, Svensson TLG, Herling SF, Jabre P, Møller AM. Family presence during resuscitation. Cochrane Database Syst Rev. 2023; 5:(5) https://doi.org/10.1002/14651858.CD013619.pub2

Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 2: ethical aspects of CPR and ECC. Circulation. 2000; 102:I12-I21

Barreto MS, Garcia-Vivar C, Mitchell M, Marcon SS. Family presence during resuscitation in emergency departments: professionals' attitudes in Brazil. Int Nurs Rev. 2018; 65:(4)567-576 https://doi.org/10.1111/inr.12490

Bashayreh I, Saifan A, Batiha AM, Timmons S, Nairn S. Health professionals' perceptions regarding family witnessed resuscitation in adult critical care settings. J Clin Nurs. 2015; 24:(17-18)2611-2619 https://doi.org/10.1111/jocn.12875

Bossaert LL, Perkins GD, Askitopoulou H European Resuscitation Council guidelines for resuscitation 2015: Section 11. The ethics of resuscitation and end-of-life decisions. Resuscitation. 2015; 95:302-311 https://doi.org/10.1016/j.resuscitation.2015.07.033

Bradley SM, Liu W, Chan PS Duration of resuscitation efforts for in-hospital cardiac arrest by predicted outcomes: insights from Get With the Guidelines − Resuscitation. Resuscitation. 2017; 113:128-134 https://doi.org/10.1016/j.resuscitation.2016.12.017

Brasel KJ, Entwistle JW, Sade RM. Should family presence be allowed during cardiopulmonary resuscitation?. Ann Thorac Surg. 2016; 102:(5)1438-1443 https://doi.org/10.1016/j.athoracsur.2016.02.011

British Medical Association, Resuscitation Council UK, Royal College of Nursing. Decisions relating to cardiopulmonary resuscitation. 2016. https//tinyurl.com/2p9hwu78 (accessed 5 December 2023)

Calder LA, Mastoras G, Rahimpour M Team communication patterns in emergency resuscitation: a mixed methods qualitative analysis. Int J Emerg Med. 2017; 10:(1) https://doi.org/10.1186/s12245-017-0149-4

Carter C, Rooney M, Notter J. Critical care nurse leadership. In: Carter C., Notter J. : Elsevier; 2021

Carter C, Notter J. Evaluation of an international health partnership to capacity build emergency, trauma and critical care nurse education and practice in Zambia: an experience from the field. Int Nurs Rev. 2023; 70:(3)266-272 https://doi.org/10.1111/inr.12813

De Stefano C, Normand D, Jabre P Family presences during resuscitation: a qualitative analysis from a national multicentred randomised clinical trial. PLoS One. 2016; 11:(6) https://doi.org/10.1371/journal.pone.0156100

Doyle CJ, Post H, Burney RE, Maino J, Keefe M, Rhee KJ. Family participation during resuscitation: an option. Ann Emerg Med. 1987; 16:(6)673-675 https://doi.org/10.1016/S0196-0644(87)80069-0

Ford K, Menchine M, Burner E Leadership and teamwork in trauma and resuscitation. West J Emerg Med. 2016; 17:(5)549-556 https://doi.org/10.5811/westjem.2016.7.29812

García-Martínez AL, Meseguer-Liza C. Emergency nurses' attitudes towards the concept of witnessed resuscitation. Rev Lat Am Enfermagem. 2018; 26 https://doi.org/10.1590/1518-8345.1382.3055

Grimes C. The effects of family-witnessed resuscitation on health professionals. Br J Nurs. 2020; 29:(15)892-896 https://doi.org/10.12968/bjon.2020.29.15.892

Guzzetta C. Family presence during resuscitation and invasive procedures. Crit Care Nurse. 2016; 36:(1)e11-e14 https://doi.org/10.4037/ccn2016980

Horowitz JM, Owyang C, Perman SM The latest in resuscitation research: highlights from the 2020 American Heart Association's Resuscitation Science Symposium. J Am Heart Assoc. 2021; 10:(16) https://doi.org/10.1161/JAHA.121.021575

Kloeck D, Meaney P, Kloeck W. Resuscitation in resource-poor setting-a southern Africa experience. ICU Management and Practice. 2017; 17:(2)96-98

Leske JS, McAndrew NS, Brasel KJ, Feetham S. Family presence during resuscitation after trauma. J Trauma Nurs. 2017; 24:(2)85-96 https://doi.org/10.1097/JTN.0000000000000271

Mentzelopoulos SD, Slowther AM, Fritz Z Ethical challenges in resuscitation. Intensive Care Med. 2018; 44:(6)703-716 https://doi.org/10.1007/s00134-018-5202-0

Molyneux EM. Cardiopulmonary resuscitation in poorly resourced settings: better to pre-empt than to wait until it is too late. Paediatr Int Child Health. 2020; 40:(1)1-6 https://doi.org/10.1080/20469047.2019.1616150

Mitchell OJL, Edelson DP, Abella BS. Predicting cardiac arrest in the emergency department. J Am Coll Emerg Physicians Open. 2020; 1:(4)321-326 https://doi.org/10.1002/emp2.12015

Mwanza KE, Stassen W, Pigoga JL, Wallis LA. The views and experiences of Zambia's emergency medicine registrars in South Africa: lessons for the development of emergency care in Zambia. Afr J Emerg Med. 2021; 11:(1)65-69 https://doi.org/10.1016/j.afjem.2020.08.002

Obermeyer Z, Abujaber S, Makar M Emergency care in 59 low- and middle-income countries: a systematic review. Bull World Health Organ. 2015; 93:(8)577-586G https://doi.org/10.2471/BLT.14.148338

Powers KA. Barriers to family presence during resuscitation and strategies for improving nurses' invitation to families. Appl Nurs Res. 2017; 38:22-28 https://doi.org/10.1016/j.apnr.2017.08.007

Pratiwi ID. Family presence during resuscitation: patient and family members' preferences and attitudes. International Journal of Research in Medical Sciences. 2018; 6:(2)394-400 https://doi.org/10.18203/2320-6012.ijrms20180275

Immediate Life Support, 5th edn. : Resuscitation Council UK; 2021

Rose S. Supporting relatives who choose to witness resuscitation attempts. Nurs Times. 2018; 114:(3)30-32

Sak-Dankosky N, Andruszkiewicz P, Sherwood PR, Kvist T. Health care professionals' concerns regarding in-hospital family-witnessed cardiopulmonary resuscitation implementation into clinical practice. Nurs Crit Care. 2018; 23:(3)134-140 https://doi.org/10.1111/nicc.12294

Sandroni C, Nolan JP. Neuroprognostication after cardiac arrest in Europe: new timings and standards. Resuscitation. 2015; 90:A4-A5 https://doi.org/10.1016/j.resuscitation.2015.02.020

Soar J, Maconochie I, Wyckoff M 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation. 2019; 145:95-150 https://doi.org/10.1016/j.resuscitation.2019.10.016

Soleimanpour H, Sadegh Tabrizi J, Jafari Rouhi A Psychological effects on patient's relatives regarding their presence during resuscitation. J Cardiovasc Thorac Res. 2017; 9:(2)113-117 https://doi.org/10.15171/jcvtr.2017.19

Tam C, Kumar S, Ivascu N. Pharmacology and physiology for anaesthesia: foundations and clinical application, 2nd edn. : Elsevier; 2019

Wang CH, Chang WT, Huang CH Factors associated with the decision to terminate resuscitation early for adult in-hospital cardiac arrest: influence of family in an East Asian society. PLoS One. 2019; 14:(3) https://doi.org/10.1371/journal.pone.0213168

World Health Organization. Emergency and trauma care. 72nd World Health Assembly. A73/31. 2019. https//tinyurl.com/n87rau72 (accessed 5 December 2023)

Ethics guidelines. 2021. https//tinyurl.com/ftpj8c36 (accessed 5 December 2023)

Critical Care

Family-witnessed resuscitation in the emergency department in a low-income country

11 January 2024
Professional
02 January 2024
Volume 33 · Issue 1

Abstract

Cardiac arrest is often a sudden and traumatic event. Family-witnessed resuscitation was first recommended by the American Heart Association over two decades ago. Since then several global professional bodies have identified a range of potential benefits for relatives; however, it remains contentious. For nurses working in emergency departments (EDs) in low-income countries, the evidence for, and experience of, family-witnessed resuscitation is limited. This article critically appraises the literature relating to the perceptions of medical professionals and critically ill patients and their families about communication, family presence and their involvement during resuscitation in the ED. Three themes relating to family-witnessed resuscitation in the ED were identified by a focused literature search. These were: leadership and communication, limitation of policies and guidelines and relatives' views. The recommendations from this review will be used to develop emergency and trauma nursing practice guidelines in Zambia, a low-income country in sub-Saharan Africa.

The emergency department (ED) is a fast-paced, complex area of nursing practice, in which nurses need to have the knowledge and skills to recognise and respond to the burden of critical illness and the high volume of patients (Mitchell et al, 2020). Cardiac arrest is a sudden, life-threatening situation, where speed of intervention is crucial. Patients may arrive in the ED already in cardiorespiratory or peri-arrest while others may deteriorate during admission. Family-witnessed resuscitation was identified as appropriate over 30 years ago (Doyle et al, 1987), and recommended by the American Heart Association in 2000. Since then international organisations have increasingly advocated the use of this practice (Bossaert et al, 2015; British Medical Association et al, 2016; Resuscitation Council UK, 2021; Yeung et al, 2021). However, it is a cause for concern that, in many settings, this has not become established practice with health professionals still stating reservations (Grimes, 2020). For emergency nurses working in low-income countries (LICs), such as Zambia, an additional challenge is the limited availability of evidence to support this intervention. Therefore, this article critically appraises the literature relating to the different professional perspectives regarding the family's presence during resuscitation in the ED.

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Resuscitation
Family-witnessed resuscitation
Emergency department
Critical care nursing