Walters D T, Tupin J P
Department of Emergency Medicine, Kern Medical Center, Bakersfield, California.
Emerg Med Clin North Am. 1991 Feb;9(1):189-206.
Emergency physicians frequently face death, yet many are unprepared to deal with the family survivors of a patient who has died unexpectedly. Without the benefit of establishing prior rapport with the family, the emergency physician must anticipate the family's grief response so that he or she can intervene to avoid an unnecessarily prolonged or morbid grief reaction. Factors predisposing to a pathologic grief response in the death of a spouse or of an infant or child must be recognized, and the physician's power to assuage survivor guilt should be used. Certain key actions in the process of notifying survivors, viewing the body, concluding the emergency department visit, and following up after the patient's death help facilitate survivor grief in the least traumatic way possible. Emergency Departments can improve their dealing with death by instituting a team approach using doctors, nurses, social workers, and clergy to better support family members in their emergency department experience and to provide a link with community service organizations helpful to the family after they leave the hospital.
急诊医生经常面对死亡，但许多人并未做好准备来应对意外死亡患者的家属。在没有与家属建立起先前融洽关系的情况下，急诊医生必须预估家属的悲伤反应，以便能够进行干预，避免不必要的长时间或病态的悲伤反应。必须认识到导致配偶、婴儿或儿童死亡时出现病理性悲伤反应的因素，并发挥医生减轻幸存者内疚感的能力。在通知幸存者、查看尸体、结束急诊就诊以及患者死亡后进行随访的过程中，某些关键行动有助于以创伤最小的方式促进幸存者的悲伤情绪缓解。急诊科可以通过采用团队协作方式来改善对死亡情况的处理，该团队由医生、护士、社会工作者和神职人员组成，以便在急诊科体验中更好地支持家庭成员，并在他们出院后与对家庭有帮助的社区服务组织建立联系。
