Warwick Medical School, University of Warwick, Gibbet Hill, Coventry, CV4 7AL, UK.
University Hospitals Birmingham NHS Foundation Trust, Bordesley Green East, Birmingham, B9 5SS, UK.
BMC Emerg Med. 2024 Nov 5;24(1):208. doi: 10.1186/s12873-024-01117-4.
Relatives of patients who have experienced an out of hospital cardiac arrest (OHCA) experience confusion and distress during resuscitation. Clear information from ambulance clinicians and the opportunity to witness the resuscitation helps them navigate the chaotic scene. However, UK-based evidence concerning relatives' experiences of unsuccessful resuscitation attempts and interactions with ambulance clinicians is lacking. This qualitative study explores those experiences to inform ambulance clinician practice.
Two ambulance services in the UK identified OHCA events attended by their clinicians within the previous two weeks. After a minimum of three months relatives of non-survivors of these events were invited to participate in either a remote or face-to-face interview. Interviews focussed on their experiences of the resuscitation attempt and interactions with ambulance clinicians, their feelings at the time, and their reflections on the event afterwards. Data were analysed using reflexive thematic analysis.
Semi-structured interviews were conducted with 14 relatives of OHCA non-survivors. Thematic analysis identified four themes. Cardiac arrest is a traumatic event for relatives, with chaotic noisy scenes increasing their distress. Many described feelings symptomatic of Post-Traumatic Stress Disorder since the event. During resuscitation, participants needed information from clinicians about what was happening, and provided information about their relatives' wishes. Participants needed reassurance from clinicians that everything possible was done to save their relative and were reassured when they could witness some of the resuscitation. Participants were surprised how long resuscitation seemed to last; some were distressed that it lasted so long.
Relatives' experiences highlight two key challenges for ambulance clinicians: (1) being aware of the tension relatives feel between needing reassurance that the crew is doing everything to save the patient and wanting to avoid prolonged and ultimately futile resuscitation attempts; and (2) having ongoing conversations with those present to inform clinical decision-making whilst managing the resuscitation attempt.
经历院外心脏骤停（OHCA）的患者的亲属在复苏过程中会感到困惑和痛苦。来自救护车临床医生的清晰信息和目睹复苏的机会有助于他们在混乱的现场中找到方向。然而，英国缺乏关于亲属在不成功的复苏尝试中的经历以及与救护车临床医生互动的证据。这项定性研究旨在探索这些经历，为救护车临床医生的实践提供信息。
英国的两家救护车服务机构在过去两周内确定了其临床医生参与的 OHCA 事件。在这些事件中，非幸存者的亲属至少在三个月后被邀请参加远程或面对面的访谈。访谈重点关注他们对复苏尝试的体验以及与救护车临床医生的互动、他们当时的感受以及事后对事件的反思。使用反思性主题分析对数据进行分析。
对 14 名 OHCA 非幸存者的亲属进行了半结构化访谈。主题分析确定了四个主题。心脏骤停对亲属来说是一个创伤性事件，嘈杂混乱的场景加剧了他们的痛苦。许多人描述了自事件发生以来出现的创伤后应激障碍症状。在复苏过程中，参与者需要从临床医生那里获取有关正在发生的事情的信息，并提供有关他们亲属意愿的信息。参与者需要从临床医生那里获得保证，尽一切可能挽救他们的亲人，当他们能够目睹一些复苏时，他们会感到放心。参与者对复苏似乎持续了很长时间感到惊讶；有些人对持续时间过长感到苦恼。
亲属的经历突显了救护车临床医生面临的两个关键挑战：（1）意识到亲属在需要保证医护人员正在尽一切努力挽救患者与希望避免长时间且最终无效的复苏尝试之间的紧张情绪；（2）在管理复苏尝试的同时，与在场人员进行持续对话，为临床决策提供信息。
