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Review
. 2022 Nov:180:11-23.
doi: 10.1016/j.resuscitation.2022.08.021. Epub 2022 Sep 7.

Family presence during adult resuscitation from cardiac arrest: A systematic review

Julie Considine  1 , Kathryn Eastwood  2 , Hannah Webster  3 , Michael Smyth  4 , Kevin Nation  5 , Robert Greif  6 , Katie Dainty  7 , Judith Finn  8 , Janet Bray  9 ; International Liaison Committee on Resuscitation (ILCOR) Education, Implementation and Teams; Basic Life Support; and Advanced Life Support Task Forces
Affiliations
Free article
Review

Family presence during adult resuscitation from cardiac arrest: A systematic review

Julie Considine et al. Resuscitation. 2022 Nov.
Free article

Abstract

Aim: Objective: To conduct a systematic review of the published evidence related to family presence during adult resuscitation from cardiac arrest.

Methods: This review, registered with PROSPERO (CRD42021242384) and reported according to PRISMA guidelines, included studies of adult cardiac arrest with family presence during resuscitation that reported one or more patient, family or provider outcomes. Three databases (Medline, CINAHL and EMBASE) were searched from inception to 10/05/2022. Two investigators screened the studies, extracted data, and assessed risks of bias using the Mixed Method Appraisal Tool (MMAT). The synthesis approach was guided by Synthesis Without Meta-Analysis (SWiM) reporting guidelines and a narrative synthesis method.

Results: The search retrieved 9,459 citations of which 31 were included: 18 quantitative studies (including two RCTs), 12 qualitative studies, and one mixed methods study. The evidence was of very low or low certainty. There were four major findings. High-certainty evidence regarding the effect of family presence during resuscitation on patient outcomes is lacking. Family members had mixed outcomes in terms of depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, and experience of witnessing resuscitation. Provider experience was variable and resuscitation setting, provider education, and provider experience were major influences on family presence during resuscitation. Finally, providers reported that a family support person and organisational guidelines were important for facilitating family presence during resuscitation.

Conclusion: The effect of family presence during resuscitation varies between individuals. There was variability in the effect of family presence during resuscitation on patient outcomes, family and provider outcomes and perceptions.

Keywords: Adult; Cardiopulmonary Resuscitation; Family; Family Health; Health Care; Health Personnel; Heart Arrest; Humans; Outcome Assessment; Psychological; Stress; Treatment Outcome.

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Conflict of interest statement

Declaration of Competing Interest This systematic review was part of the ILCOR continuous evidence evaluation process, which is guided by a rigorous conflict of interest policy (see www.ilcor.org). Kathryn Eastwood is a member of the International Liaison Committee on Resuscitation (ILCOR) Education Implementation and Teams (EIT) Task Force. Kevin Nation was a member of the ILCOR Advanced Lie Support (ALS) Task Force at the commencement of this systematic review and is now a member of the ILCOR EIT Task Force. Robert Greif is European Resuscitation Council Director of Guidelines and ILCOR, and ILCOR EIT Taskforce Chair. Julie Considine is an emeritus member of ILCOR Basic Life Support (BLS) Task Force and Katie Dainty is a member of the ILCOR BLS Task Force. Janet Bray is ILCOR BLS Task Force Chair and Michael Smyth is Deputy Chair. Judith Finn is a member of the ILCOR Science Advisory Committee. None of the other authors declared a conflict of interest.