Institution for Emergency Medicine, Arnsberg, Germany.
Department of Anaesthesiology and Intensive Care Medicine, Evangelisches Krankenhaus BETHESDA zu Duisburg GmbH, Duisburg, Nordrhein-Westfalen, Germany.
BMJ Open. 2022 Apr 5;12(4):e056798. doi: 10.1136/bmjopen-2021-056798.
Guidelines recommend family presence to be offered during cardiopulmonary resuscitation (CPR). Data on the effects of family presence on the quality of CPR and rescuers' workload and stress levels are sparse and conflicting. This randomised trial investigated the effects of family presence on quality of CPR, and rescuers' perceived stress.
Prospective randomised single-blind trial.
Voluntary workshops of educational courses.
1085 physicians (565 men) randomised to 325 teams entered the trial. 318 teams completed the trial without protocol violation.
Teams were randomised to a family presence group (n=160) or a control group (n=158) and to three versions of leadership: (a) designated at random, (b) designated by the team or (c) left open. Thereafter, teams were confronted with a simulated cardiac arrest which was video-recorded. Trained actors played a family member according a scripted role.
The primary endpoint was hands-on time. Secondary outcomes included interaction time, rescuers' perceived task load and adherence to CPR algorithms.
Teams interacted with the family member during 24 (17-36) % of the time spent for resuscitation. Family presence had no effect on hands-on time (88% (84%-91%) vs 89% (85%-91%); p=0.18). Family presence increased frustration (60 (30-75) vs 45 (30-70); p<0.001) and perceived temporal (75 (55-85) vs 70 (50-80); p=0.001) and mental demands (75 (60-85) vs 70 (55-80); p=0.009), but had no relevant effect on CPR performance markers. Leadership condition had no effects.
Interacting with a family member occupied about a quarter of the time spent for CPR. While this additional task was associated with an increase in frustration and perceived temporal and mental demands, family presence had no relevant negative effect on the quality of CPR.
DRKS00024759.
指南建议在心肺复苏（CPR）期间提供家属在场。关于家属在场对 CPR 质量以及救援人员工作负荷和压力水平影响的数据很少且相互矛盾。本随机试验旨在研究家属在场对 CPR 质量和救援人员感知压力的影响。
前瞻性随机单盲试验。
教育课程自愿工作坊。
1085 名医生（565 名男性）随机分为 325 个团队参加试验。318 个团队完成了没有违反方案的试验。
团队被随机分为家属在场组（n=160）或对照组（n=158），并分为三种领导方式：（a）随机指定，（b）团队指定或（c）开放选择。此后，团队面临模拟心搏骤停，该模拟心搏骤停被录像记录。受过训练的演员根据剧本扮演家属角色。
主要终点是动手时间。次要结局包括互动时间、救援人员感知的任务负荷和对 CPR 算法的依从性。
团队与家属互动的时间占复苏时间的 24%（17-36%）。家属在场对动手时间没有影响（88%（84%-91%）与 89%（85%-91%）；p=0.18）。家属在场增加了挫败感（60（30-75）与 45（30-70）；p<0.001）和感知的时间（75（55-85）与 70（50-80）；p=0.001）和心理需求（75（60-85）与 70（55-80）；p=0.009），但对 CPR 绩效标志物没有相关影响。领导条件没有影响。
与家属互动占据了 CPR 时间的四分之一左右。虽然这项额外的任务与挫败感的增加以及感知的时间和心理需求有关，但家属在场对 CPR 质量没有相关的负面影响。
DRKS00024759。
