Ahrens W, Hart R, Maruyama N
Department of Emergency Medicine, University of Illinois at Chicago, USA.
J Emerg Med. 1997 Sep-Oct;15(5):601-3. doi: 10.1016/s0736-4679(97)00119-4.
Managing the family conference in the emergency department after the sudden death of a child is difficult and, when mishandled, can be deleterious to the patient's family. We surveyed parents of children who died in an emergency department setting in an effort to elicit information that will help emergency physicians tell parents that their child has died. A 24-question survey was distributed to 60 parents identified by the Illinois chapter of the Sudden Infant Death Syndrome Alliance. Results were included if the parents indicated that their child was pronounced dead on arrival or died in an emergency department. If the victim was over 16 years of age, had a terminal illness, or died after hospitalization, results were excluded. Thirty-seven parents completed the survey. Seventy-six percent felt that it was the attending physician's responsibility to inform the family that the child had died. Holding the dead child was helpful for 88%. Seventy-six percent felt that being asked about organ donation would not be offensive. For most parents, having the child's clothes returned was important. Fully 92% of the respondents would have liked a physical memento of the child, such as a print or mold of the child's hand or a lock of hair. Most parents felt that a follow-up telephone call would be helpful, although only a small minority received such a call. Parents whose child died in an emergency department provided some concrete suggestions for emergency physicians regarding informing parents that their child died. Although the majority of children died of sudden infant death syndrome, the results may be applicable to other pediatric deaths.
在儿童突然死亡后，在急诊科组织家属会议是困难的，而且如果处理不当，可能会对患者家属造成伤害。我们对在急诊科死亡儿童的家长进行了调查，以获取有助于急诊医生告知家长其孩子已死亡的信息。一份包含24个问题的调查问卷被分发给由婴儿猝死综合征联盟伊利诺伊分会确定的60位家长。如果家长表示他们的孩子到达时被宣布死亡或在急诊科死亡，则纳入结果。如果受害者年龄超过16岁、患有绝症或在住院后死亡，则排除结果。37位家长完成了调查。76%的家长认为告知家属孩子已死亡是主治医生的责任。抱着死去的孩子很有帮助，这一比例为88%。76%的家长认为被问及器官捐赠不会冒犯他们。对大多数家长来说，归还孩子的衣服很重要。整整92%的受访者希望得到孩子的实物纪念品，比如孩子的手印或模子、一缕头发。大多数家长认为后续的电话回访会有帮助，尽管只有一小部分家长接到过这样的电话。孩子在急诊科死亡的家长就告知家长孩子死亡一事给急诊医生提供了一些具体建议。尽管大多数儿童死于婴儿猝死综合征，但这些结果可能适用于其他儿科死亡情况。
