Shall we stop - Discontinuing resuscitation
“The only randomized, prospective evaluation of family presence during CPR to date was terminated after enrollment of only 25 patients. Clinical teams had become so convinced of the benefits to relatives that investigators feared the randomization process would be intentionally compromised by staff.10”
Keywords: resuscitation, breaking bad news, paramedics, family communication, emergency medicine, clinical decisions, patient care, emotional intelligence, healthcare, end-of-life care
SummaryIn this episode, Josh and Simon discuss the critical and sensitive topic of discontinuing resuscitation efforts. They explore the emotional and practical aspects of breaking bad news to families, emphasizing the importance of communication, empathy, and the roles of paramedics in these challenging situations. The conversation highlights the need for a structured approach to family liaison during resuscitation, the dynamics of team roles, and the significance of preparing families for the realities of their loved ones' conditions. Through personal anecdotes and reflections, they underscore the human element of emergency care and the impact of effective communication on families during traumatic moments.
Takeaways
Discontinuing resuscitation is a deeply human moment.
Effective communication with families is crucial.
The role of family liaison should be prioritized in resuscitation teams.
Empathy and emotional intelligence are key in breaking bad news.
Preparation for families can ease the process of grief.
Using clear and direct language is essential when discussing death.
Understanding family dynamics can improve communication outcomes.
The importance of maintaining dignity for the deceased is paramount.
Reflection on past experiences can enhance future practice.
Team dynamics play a significant role in family communication during resuscitation.
Chapters
00:00Introduction and Importance of the Topic
03:48Who Should Deliver Bad News?
14:09How to Deliver Bad News Effectively
25:50Navigating Difficult Conversations
26:50Fact Finding and Initial Communication
29:13Warning Shots: Setting Expectations
30:52Understanding Patient Wishes
35:17Facilitating Family Involvement
38:28Delivering Bad News Effectively
43:31Learning from Experience
52:25Family Involvement in Resuscitation Decisions
53:56The Importance of Dignity in Resuscitation
55:31Handling Suspicious Deaths and Coroner's Involvement
57:36Preparing the Family for the Resuscitation Outcome
59:43Communicating the Decision to Stop Resuscitation
01:00:42Post-Resuscitation Care and Family Interaction
01:03:25Handling Non-Suspicious Deaths
01:04:59Last Offices and Preparing the Deceased
01:08:23Creating a Peaceful Environment for the Family
01:11:54Cultural Sensitivity in End-of-Life Care
01:13:11Reflections on the Emotional Impact of Resuscitation