Family Presence In Trauma Resuscitation: A Lawsuit Risk?

Nearly two decades ago, the Emergency Nursing Association (ENA) resolved that family presence during resuscitation and invasive procedures was a patient right. They thought that it was beneficial both to the patient and their family members.

As you might imagine, this was hotly contested by emergency physicians and trauma surgeons for years. Shortly after the release of the resolution, a survey was sent to members of the American Association for the Surgery of Trauma (AAST, trauma surgeons) and the ENA (nurses). This survey was designed to gauge the attitudes and beliefs of their members with respect to family presence during trauma resuscitation.

Here are the factoids:

  • The entire AAST membership (813) and a random 10% of the ENA membership (2988) were polled
  • Response rate was 43% overall, not bad
  • AAST members tended to be male, older, and had more trauma experience (duh!)
  • 98% of AAST members thought that family presence was inappropriate, vs 80% of ENA members
  • A similar proportion of members believed that family presence would interfere with patient care, increase stress on the trauma team, and increase malpractice risk
  • All differences were statistically significant (sort of)

Bottom line: This was a weird study. If you look closely at the numbers, it appears that the same surgeons and nurses answered all the questions exactly the same way. The n for each question is virtually the same, plus or minus five respondents.  

And a lot has changed in the past 15 years. This study took place when the family presence concept was relatively new. Attitudes have changed considerably, and family presence, especially parents of children, is much more routine. 

There is still little data, but anecdotal experience would indicate that there is probably less likelihood of lawsuits when family is present. It is the ultimate good communication, and in cases resulting in death, the family member can see that the team is doing everything possible for their loved one. 

But remember, don’t just throw family members into your resuscitation room. Assign a nurse as a “medical interpreter” to explain what is going on, make sure they do not impede the team, and keep them from keeling over on the floor and getting hurt.

Reference: Family Presence during Trauma Resuscitation: A Survey of AAST and ENA Members. J Trauma 48(6):1015-1024, 2000.

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