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

  • Julie Considine
    Correspondence
    Corresponding author at: School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia.
    Affiliations
    School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia

    Centre for Quality and Patient Safety Research – Eastern Health Partnership, Box Hill, Australia
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  • Kathryn Eastwood
    Affiliations
    Public Health and Preventive Medicine, Monash University, Melbourne, Australia

    Ambulance Victoria, Victoria, Australia
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  • Hannah Webster
    Affiliations
    Monash University, Epidemiology and Preventive Medicine, Melbourne, Australia
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  • Michael Smyth
    Affiliations
    Warwick Clinical Trials Unit, University of Warwick, Coventry, United Kingdom
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  • Kevin Nation
    Affiliations
    New Zealand Resuscitation Council, Wellington, New Zealand
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  • Robert Greif
    Affiliations
    Department of Anesthesiology and Pain Therapy, Bern University Hospital, Inselspital, Bern, Switzerland

    School of Medicine, Sigmund Freud University Vienna, Vienna Austria
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  • Katie Dainty
    Affiliations
    Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

    North York General Hospital, North York, Ontario, Canada
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  • Judith Finn
    Affiliations
    Prehospital, Resuscitation & Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Bentley, Western Australia, Australia

    St John Western Australia, Australia
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  • Janet Bray
    Affiliations
    Monash University, Epidemiology and Preventive Medicine, Melbourne, Australia

    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Bentley, Western Australia, Australia
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  • For theInternational Liaison Committee on Resuscitation (ILCOR) Education, Implementation and Teams; Basic Life Support; and Advanced Life Support Task Forces

      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

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