Family-Witnessed Resuscitation

Abstract

To the Editor:We thank Dr. Creamer for his interest in our article, and we acknowledge his expertise in pediatric intensive care and family- witnessed resuscitation (FWR) for pediatric patients. We agree with Dr. Creamer that pediatric medicine, by its very nature, requires a more family centered approach, in which there is continuous interaction between health professionals and parents functioning as guardians and decision makers.In our original article, we stated that the results of opinions toward the pediatric patient should be interpreted with caution, as only 20 of the 494 physicians surveyed were trained in pediatric specialties. We warned that our pediatric resuscitation data might not reflect the opinions of the larger community of pediatric intensivists. In fact, Dr. Creamer’s published data show that he and many other pediatricians have embraced FWR with great success and satisfaction.Our survey data did not show a statistically significant difference of opinion toward FWR of children when pediatric-trained health-care professionals were compared to adult health-care professionals (26.1% vs 14.2%, respectively; p = 0.138); however, the subgroup of 12 primary pediatricians was more likely to favor FWR for children compared to adult-trained health-care professionals (41.7% vs 14.2%, respectively; p = 0.022). While subgroup analysis supports Dr. Creamer’s position, we believe that the number of pediatricians we surveyed was too small to draw definitive conclusions.In summary, we agree with Dr. Creamer that this area requires more research and discussion before FWR can be “advocated wholesale.” In the interim, hospital leaders should consider each patient and family situation individually and should ensure that physicians and nurses are trained to support FWR in appropriate circumstances. To the Editor: We thank Dr. Creamer for his interest in our article, and we acknowledge his expertise in pediatric intensive care and family- witnessed resuscitation (FWR) for pediatric patients. We agree with Dr. Creamer that pediatric medicine, by its very nature, requires a more family centered approach, in which there is continuous interaction between health professionals and parents functioning as guardians and decision makers. In our original article, we stated that the results of opinions toward the pediatric patient should be interpreted with caution, as only 20 of the 494 physicians surveyed were trained in pediatric specialties. We warned that our pediatric resuscitation data might not reflect the opinions of the larger community of pediatric intensivists. In fact, Dr. Creamer’s published data show that he and many other pediatricians have embraced FWR with great success and satisfaction. Our survey data did not show a statistically significant difference of opinion toward FWR of children when pediatric-trained health-care professionals were compared to adult health-care professionals (26.1% vs 14.2%, respectively; p = 0.138); however, the subgroup of 12 primary pediatricians was more likely to favor FWR for children compared to adult-trained health-care professionals (41.7% vs 14.2%, respectively; p = 0.022). While subgroup analysis supports Dr. Creamer’s position, we believe that the number of pediatricians we surveyed was too small to draw definitive conclusions. In summary, we agree with Dr. Creamer that this area requires more research and discussion before FWR can be “advocated wholesale.” In the interim, hospital leaders should consider each patient and family situation individually and should ensure that physicians and nurses are trained to support FWR in appropriate circumstances. Family-Witnessed ResuscitationCHESTVol. 124Issue 2PreviewTo the Editor: Full-Text PDF