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Witnessed Paeds Resus - your views

Bob Waddell II bobwaddell at bresnan.net
Sun Apr 23 12:58:18 BST 2006


An interesting discussion with a high probability of no one correct answer. 
 While I agree with the points about the primary response team needing to 
concentrate on the child, I have had the honor to work with (in my opinion) 
great Peds Docs such as Frank Mortorano, Roger Barkin, Joe Wright, and others 
who have strong convictions related to caring for the child, but also have 
strong convictions towards the family.  In the 80's Frank was advocating for 
Family presence - long before Family Centered Care be came a significant 
chant.  His contention was that the family healed better if they knew their 
child had been cared for at the highest levels available at the time and 
place.  He went on to teach us, legally, we frequently do better when there 
are witnesses.  Antedotally there is more itigation because of poor attitudes 
towards the family and questions being formulated in the lobby than from 
witnesses that see effort and humanity for the healthcare team.

Especially for the Physicians that feel family presence is a poor idea, can 
you honestly say that if this was your child in crisis, you would openly allow 
or voluntarily not follow your child into the care/resc area and stay in the 
lobby/family room?  Even if it were at your hospital?  What good for the 
trained experts MIGHT be good for the other humans we call family soo.  Just 
my thoughts.

Take care,

Bob Waddell II


On Sun, 23 Apr 2006 07:29:36 -0400
  "Ronald Gross" <Rgross at harthosp.org> wrote:
> I have to agree with Steve - while I understand that the parents of a
> sick/injured child want to be with their kids when care is rendered,
> they have no moire place in the Trauma room than they do in the OR. 
> Staff memebrs caring for sick/injured kids need to be able to dedicate
> ALL of their energies ALL OF THE TIME to the care of the kid, NOT
> consoling and informing the parents - many of whom will need extended
> time to "inform".
> 
> I got yer back, too, Steve.
> 
> Anyone got mine?
> 
>>>> flysurg at aol.com 04/22 5:58 PM >>>
> This BS rears its ugly head again and again. Family members have no
> place in trauma resuscitations until all invasive procedures have been
> completed, if at all. Medical/ peds codes in ICU's are not the same.
> This is just another lame attempt to nursify the practice of trauma
> surgery. Fire away!
> 
> Steve Smith 
> 
> -----Original Message-----
>From: Nick Macartney <nick at macartney.org>
> To: 'Trauma &amp; Critical Care mailing list' <trauma-list at trauma.org>
> Sent: Fri, 21 Apr 2006 07:30:55 +0100
> Subject: RE: Witnessed Paeds Resus - your views
> 
> 
> Spent 2 hours yesterday resuscitating a 7 day old baby - not trauma,
> but
> still rather sick. Parents were present all the time. We all made a
> conscious effort to keep them up to speed. Parents were very sensible,
> as
> has always been my experience.
> Nick Macartney 
> 
>> -----Original Message-----
>> From: trauma-list-bounces at trauma.org 
>> [mailto:trauma-list-bounces at trauma.org] On Behalf Of Andrew Davidson
>> Sent: 20 April 2006 18:21
>> To: trauma-list at trauma.org 
>> Subject: Witnessed Paeds Resus - your views
>> 
>> Dear All
>> 
>> Following a recent discussion with some fellow med students 
>> regarding witnessed resuscitation in paediatric trauma/arrest 
>> - I was interested to hear the views of those more qualified 
>> than myself! 
>> 
>> Bearing in mind the following (non-typical) scenario:
>> 
>> Father arrives at ED carrying 6 year old child - involved in 
>> vehicle versus pedestrian MVA. Father transported child to 
>> hospital - no EMS involvement. Nursing staff take child from 
>> father and rush her to resuscitation area and issue a trauma 
>> call. The child is making no respiratory effort, is mutiply 
>> injured and is in cardiac arrest. The frantic father demands 
>> to be present for the resuscitation attempt but is asked to 
>> remain outside - much to his distress.
>> 
>> I have read with interest various published materials 
>> regarding witness adult resus - but was interested to hear 
>> your views (and experiences) regarding paeds patients.
>> 
>> Andrew
>> 
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