"Am I also going to die, doctor?" A systematic review of the impact of in-hospital patients witnessing a resuscitation of another patient

Eur J Cardiovasc Nurs. 2017 Oct;16(7):585-594. doi: 10.1177/1474515117705938. Epub 2017 Apr 13.

Abstract

Background: There is a growing interest in the impact of family-witnessed resuscitation. However, evidence about the effect of hospitalised patients witnessing other patients' resuscitations is limited.

Aim: The aim of this systematic review is to explore the existing evidence related to the impact on patients who witness resuscitation attempts on other patients in hospital settings.

Methods: The databases BNI, CINAHL, EMBASE, MEDLINE and PsycINFO were searched with the terms 'patient', 'inpatient', 'resuscitation', 'CPR', 'cardiopulmonary resuscitation' and 'witness'. The search strategy excluded the terms 'out-of-hospital', 'family' and 'relative'. The inclusion criteria were: studies related to patients exposed to a resuscitation attempt performed on another patient; quantitative and qualitative design; and physiological or psychological outcome measures. No limitations of date, language or settings were applied.

Results: Five of the 540 identified studies were included: two observational studies with control groups and three qualitative studies with interviews and focus groups. Articles were published between 1968 and 2006 and were mostly rated to have a low quality of evidence. Quantitative results of the observational studies showed an increased heart rate in the study group witnessing a resuscitation ( p = 0.05), increased systolic blood pressure ( p < 0.01) and increased anxiety ( p < 0.01). The qualitative studies highlighted the coping strategies adopted by exposed patients in response to witnessing resuscitation, including denial and dissociation.

Conclusions: Our findings suggest that patients may find witnessing resuscitation to be a stressful experience. However, the evidence is sparse and mainly of poor quality. Further research is needed in order to better understand the impacts of patients witnessing a resuscitation of another patient and to identify effective support systems.

Keywords: Hospital; emergency treatment; patients; resuscitation; trauma and stressor related disorders.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude to Death*
  • Cardiopulmonary Resuscitation / psychology*
  • Emergency Medical Services / methods
  • Female
  • Heart Arrest / mortality*
  • Heart Arrest / therapy*
  • Humans
  • Inpatients / psychology*
  • Male
  • Middle Aged
  • United Kingdom