Emergency Medical Service Providers' Experience with Family Presence During Cardiopulmonary Resuscitation: Urban Versus Suburban Setting

2.50
Hdl Handle:
http://hdl.handle.net/10755/162658
Type:
Presentation
Title:
Emergency Medical Service Providers' Experience with Family Presence During Cardiopulmonary Resuscitation: Urban Versus Suburban Setting
Abstract:
Emergency Medical Service Providers' Experience with Family Presence During Cardiopulmonary Resuscitation: Urban Versus Suburban Setting
Conference Sponsor:Emergency Nurses Association
Conference Year:2007
Author:Goldstein, Mark, RN, BSN, EMT-P, I/C
P.I. Institution Name:William Beaumont Hospital
Title:EMS Coordinator
Contact Address:3601 W. Thirteen Mile Rd., Royal Oak, MI, 48073, USA
Contact Telephone:(248) 898-2386
Co-Authors:Robert Swor, DO, FACEP; Alex Magdy, BS, MD; Robert Dunne, MD, FACEP
[Research Poster] Purpose: In light of the growing movement toward including family members as witnesses to resuscitation attempts, there has been a dearth of research on the topic, including medical provider performance outcomes. The majority of this literature, however, addresses care in the relatively well-controlled environment such as an emergency department (ED) resuscitation suite. To address this concern, we sought to describe the experiences and perceptions of emergency medical service (EMS) providers, whom typically have extensive experience with family-witnessed resuscitation attempts. In addition, we attempted to determine whether differences in these experiences and perceptions exist between urban and suburban EMS providers.

Design: A descriptive study design was used.

Setting: EMS providers transporting patients to one or two large, Midwestern teaching Level 1 trauma centers within an urban and suburban EMS system.

Sample: Convenience sample of 128 EMS providers (59 urban; 69 suburban) from June 2004 - July 2004.

Methodology: A survey was conducted to ascertain experiences with and perceptions of pre-hospital family presence during cardiopulmonary resuscitation (CPR). Providers were queried regarding their demographic information, perceptions of resuscitating patients in the presence of family members, and their attitudes toward this practice. The survey had 21 questions (dichotomous yes/no or a 5-point Likert scale). Comparisons between urban and suburban providers were conducted using Wilcoxon rank sum tests and chi-square tests, where appropriate. No priori sample size or power analysis was conducted.

Results: Of the 128 EMS providers surveyed, 70.1% were emergency medical technician-paramedics (EMT-P) and 29.9% were EMT-Basics (EMT-B). Subjects averaged 12.3 years of experience. Nearly all (122) had performed CPR in the presence of family members, with most (77%) performing greater than 20 during their career. The majority of urban (75.9%) and suburban (60.3%) providers felt it was inappropriate for family to witness resuscitations (p = 0.068). Over half of all providers reported feeling uncomfortable with family presence (urban = 31.5%; suburban = 44.8%; p = 0.136) and few preferred that family witness the resuscitation (urban versus = 13.2%; suburban = 15.4%; p = 0.738). Less than half believed that family were better prepared to accept the death of the patient (urban = 37.0%; suburban = 37.6%; p = 0.939). Approximately half felt comfortable providing emotional support (66.0% urban versus 53.7% suburban; p = 0.173). Urban providers (53.7%) more often reported that family caused a negative impact during resuscitation than suburban providers (36.8%) (p = 0.061). Urban providers (66.7%) were more likely to report feeling threatened by family members during resuscitation than suburban providers (39.7%) (p = 0.003), and felt that family often interfered with their ability to perform resuscitations (35.6% versus 16.4%, p = 0.014).

Conclusions: This study identifies that EMS providers often provide support to families during resuscitation attempts. These results indicate that urban and suburban providers have similar perceptions regarding family member presence. The results of this survey indicate that EMS providers are uncomfortable with family presence during resuscitation attempts and that they do not perceive there to be benefit for family members who witness the resuscitation attempt. While urban providers tended to report more negative experiences and perceptions, there were minimal differences between the two groups. As there are many fundamental differences between EMS resuscitation and ED resuscitation, this information suggests that education and training programs for EMS providers and ED nurses should be specifically designed and implemented to assist them in this counseling role. Systems should have support services for family members of resuscitation patients. Further research should address the impact on behaviors and practices of ED nurses.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEmergency Medical Service Providers' Experience with Family Presence During Cardiopulmonary Resuscitation: Urban Versus Suburban Settingen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162658-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Emergency Medical Service Providers' Experience with Family Presence During Cardiopulmonary Resuscitation: Urban Versus Suburban Setting</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Goldstein, Mark, RN, BSN, EMT-P, I/C</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">William Beaumont Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">EMS Coordinator</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">3601 W. Thirteen Mile Rd., Royal Oak, MI, 48073, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(248) 898-2386</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">mgoldstein@beaumonthospitals.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Robert Swor, DO, FACEP; Alex Magdy, BS, MD; Robert Dunne, MD, FACEP</td></tr><tr><td colspan="2" class="item-abstract">[Research Poster] Purpose: In light of the growing movement toward including family members as witnesses to resuscitation attempts, there has been a dearth of research on the topic, including medical provider performance outcomes. The majority of this literature, however, addresses care in the relatively well-controlled environment such as an emergency department (ED) resuscitation suite. To address this concern, we sought to describe the experiences and perceptions of emergency medical service (EMS) providers, whom typically have extensive experience with family-witnessed resuscitation attempts. In addition, we attempted to determine whether differences in these experiences and perceptions exist between urban and suburban EMS providers.<br/><br/>Design: A descriptive study design was used.<br/><br/>Setting: EMS providers transporting patients to one or two large, Midwestern teaching Level 1 trauma centers within an urban and suburban EMS system.<br/><br/>Sample: Convenience sample of 128 EMS providers (59 urban; 69 suburban) from June 2004 - July 2004. <br/><br/>Methodology: A survey was conducted to ascertain experiences with and perceptions of pre-hospital family presence during cardiopulmonary resuscitation (CPR). Providers were queried regarding their demographic information, perceptions of resuscitating patients in the presence of family members, and their attitudes toward this practice. The survey had 21 questions (dichotomous yes/no or a 5-point Likert scale). Comparisons between urban and suburban providers were conducted using Wilcoxon rank sum tests and chi-square tests, where appropriate. No priori sample size or power analysis was conducted.<br/><br/>Results: Of the 128 EMS providers surveyed, 70.1% were emergency medical technician-paramedics (EMT-P) and 29.9% were EMT-Basics (EMT-B). Subjects averaged 12.3 years of experience. Nearly all (122) had performed CPR in the presence of family members, with most (77%) performing greater than 20 during their career. The majority of urban (75.9%) and suburban (60.3%) providers felt it was inappropriate for family to witness resuscitations (p = 0.068). Over half of all providers reported feeling uncomfortable with family presence (urban = 31.5%; suburban = 44.8%; p = 0.136) and few preferred that family witness the resuscitation (urban versus = 13.2%; suburban = 15.4%; p = 0.738). Less than half believed that family were better prepared to accept the death of the patient (urban = 37.0%; suburban = 37.6%; p = 0.939). Approximately half felt comfortable providing emotional support (66.0% urban versus 53.7% suburban; p = 0.173). Urban providers (53.7%) more often reported that family caused a negative impact during resuscitation than suburban providers (36.8%) (p = 0.061). Urban providers (66.7%) were more likely to report feeling threatened by family members during resuscitation than suburban providers (39.7%) (p = 0.003), and felt that family often interfered with their ability to perform resuscitations (35.6% versus 16.4%, p = 0.014). <br/><br/>Conclusions: This study identifies that EMS providers often provide support to families during resuscitation attempts. These results indicate that urban and suburban providers have similar perceptions regarding family member presence. The results of this survey indicate that EMS providers are uncomfortable with family presence during resuscitation attempts and that they do not perceive there to be benefit for family members who witness the resuscitation attempt. While urban providers tended to report more negative experiences and perceptions, there were minimal differences between the two groups. As there are many fundamental differences between EMS resuscitation and ED resuscitation, this information suggests that education and training programs for EMS providers and ED nurses should be specifically designed and implemented to assist them in this counseling role. Systems should have support services for family members of resuscitation patients. Further research should address the impact on behaviors and practices of ED nurses.</td></tr></table>en_GB
dc.date.available2011-10-27T10:31:56Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:31:56Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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