Supporting Families and Our Own

Abstract

Out-of-hospital cardiac arrest (OHCA) can have significant adverse sequelae for both the patient’s families, as well as the responding EMS clinicians. Despite advances in medicine, 90% of OHCA result in death. The sudden and unexpected nature of these events, adds to the complexity of grief for the surviving family members. OHCA specifically has been shown to have deleterious mental health impacts on EMS clinicians who have self-reported experiencing negative emotions after delivering bad news to families such as a death notification. Given the grim prognosis associated with OHCA outcomes and associated emotional fallout, we must find ways to better support our patients, families, and EMS clinicians. The goal of this paper is to offer recommendations and tools that can be used by EMS clinicians to better address the emotional burden experienced by families during an OHCA resuscitation. Many Pre-hospital clinicians receive limited training around the psychologic and emotional consequences that accompany OHCA scenarios. Currently no national curriculum or writings that the authors are aware of have covered the concept of how to run an emotionally supportive OHCA. The following is an expert consensus of recommendations from a group of experienced EMS clinicians, a child life specialist, a licensed clinical social worker and physicians with backgrounds in emergency medicine, palliative care and EMS. The strategies outlined would ideally be utilized by first responders helping to anticipate and subsequently support the emotional needs of families. The strategies range from ways to enhance communication, help combat common misperceptions from families around cardiac arrest and prepare EMS clinicians for what to do if a resuscitation is unsuccessful. Ultimately the goal of this paper is to provide the tools to help EMS clinicians better align themselves with families to minimize the emotional impact on all involved.