Relatives’ experiences of unsuccessful out-of-hospital cardiopulmonary resuscitation attempts: a qualitative analysis

Abstract Aim 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-bas...

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Main Authors: Caroline Huxley, Eleanor Reeves, Justin Kearney, Galina Gardiner, Karin Eli, Rachael Fothergill, Gavin D. Perkins, Michael Smyth, Anne-Marie Slowther, Frances Griffiths
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Emergency Medicine
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Online Access:https://doi.org/10.1186/s12873-024-01117-4
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author Caroline Huxley
Eleanor Reeves
Justin Kearney
Galina Gardiner
Karin Eli
Rachael Fothergill
Gavin D. Perkins
Michael Smyth
Anne-Marie Slowther
Frances Griffiths
author_facet Caroline Huxley
Eleanor Reeves
Justin Kearney
Galina Gardiner
Karin Eli
Rachael Fothergill
Gavin D. Perkins
Michael Smyth
Anne-Marie Slowther
Frances Griffiths
author_sort Caroline Huxley
collection DOAJ
description Abstract Aim 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. Methods 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. Results 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. Conclusion 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.
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spelling doaj-art-2e71cdf4fcb14a52872622247a60755a2025-08-20T02:49:56ZengBMCBMC Emergency Medicine1471-227X2024-11-012411810.1186/s12873-024-01117-4Relatives’ experiences of unsuccessful out-of-hospital cardiopulmonary resuscitation attempts: a qualitative analysisCaroline Huxley0Eleanor Reeves1Justin Kearney2Galina Gardiner3Karin Eli4Rachael Fothergill5Gavin D. Perkins6Michael Smyth7Anne-Marie Slowther8Frances Griffiths9Warwick Medical School, University of WarwickUniversity Hospitals Birmingham NHS Foundation TrustLondon Ambulance Service NHS TrustWarwick Medical School, University of WarwickWarwick Medical School, University of WarwickLondon Ambulance Service NHS TrustWarwick Medical School, University of WarwickWarwick Medical School, University of WarwickWarwick Medical School, University of WarwickWarwick Medical School, University of WarwickAbstract Aim 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. Methods 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. Results 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. Conclusion 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.https://doi.org/10.1186/s12873-024-01117-4Out of hospital cardiac arrest (OHCA)ResuscitationAmbulance cliniciansRelatives
spellingShingle Caroline Huxley
Eleanor Reeves
Justin Kearney
Galina Gardiner
Karin Eli
Rachael Fothergill
Gavin D. Perkins
Michael Smyth
Anne-Marie Slowther
Frances Griffiths
Relatives’ experiences of unsuccessful out-of-hospital cardiopulmonary resuscitation attempts: a qualitative analysis
BMC Emergency Medicine
Out of hospital cardiac arrest (OHCA)
Resuscitation
Ambulance clinicians
Relatives
title Relatives’ experiences of unsuccessful out-of-hospital cardiopulmonary resuscitation attempts: a qualitative analysis
title_full Relatives’ experiences of unsuccessful out-of-hospital cardiopulmonary resuscitation attempts: a qualitative analysis
title_fullStr Relatives’ experiences of unsuccessful out-of-hospital cardiopulmonary resuscitation attempts: a qualitative analysis
title_full_unstemmed Relatives’ experiences of unsuccessful out-of-hospital cardiopulmonary resuscitation attempts: a qualitative analysis
title_short Relatives’ experiences of unsuccessful out-of-hospital cardiopulmonary resuscitation attempts: a qualitative analysis
title_sort relatives experiences of unsuccessful out of hospital cardiopulmonary resuscitation attempts a qualitative analysis
topic Out of hospital cardiac arrest (OHCA)
Resuscitation
Ambulance clinicians
Relatives
url https://doi.org/10.1186/s12873-024-01117-4
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