Clinician’s Corner: Meeting family care needs during resuscitative procedures and cardiac arrest in the emergency department


  • Matthew Douma
  • Christopher Picard
  • Karlin Su
  • Calah Myhre
  • Katherine Smith
  • Carmel Montgomery



Emergency nurses in Canada provide care to many thousands of critically ill and injured patients, and their families, each year (Rowe et al., 2020). Unfortunately, some Emergency Department (ED) patients and families report a lack of psychosocial and emotional caring (Gordon et al., 2010). Many resuscitative processes and procedures have been described as dehumanizing and traumatic for families (De Stefano et al., 2016; Jang & Choe, 2019). Significant negative emotional and physiological impacts may remain after hospitalization for the patient and their loved ones, whether receiving care for medical, (Davidson & Harvey, 2016) trauma, (McGahey-Oakland et al., 2007) or cardiac arrest presentations (Leske et al., 2013). Families of patients who survive (and those who do not survive) have reported persistent negative psychological effects weeks and months after receiving care in the ED (Jang & Choe, 2019; Keyes et al., 2014; Sawyer et al., 2020).

Author Biographies

Matthew Douma

Matthew Douma, PhD(c), RN, is a resuscitation scientist, a PhD candidate at University College Dublin, editor of CJEN and a recovering emergency nurse.

Christopher Picard

Christopher T. Picard, CD, MN, RN, is a Clinical Nurse Educator and Researcher from Edmonton, Alberta; his research interests are the intersections of resuscitation and informatics. His research is focused on hemorrhage control, and cardiovascular and resuscitation care.

Karlin Su

Karlin Su, BScN, RN, is an Emergency Registered Nurse working at the Royal Alexandra Hospital and NorthEast Community Health Centre in Edmonton, Alberta. In addition, Kar Lin is completing full-time studies in the Master of Nursing Nurse Practitioner program at the University of Alberta.

Calah Myhre

Calah Myhre, BScN, RN, is a second-year medical student at the University of Alberta. In addition, Calah is a Registered Nurse, working casually in the intensive care units at the Royal Alexandra Hospital and the Foothills Medical Centre.

Katherine Smith

Katherine E. Smith, MD, FRCPC, is a full-time Emergency Physician working at the Royal Alexandra Hospital and Stollery Children’s Hospital Emergency Departments, in addition to being a STARS transport physician and Trauma Team Leader. Dr. Smith is also a Clinical Lecturer and Social Accountability Lead with the Faculty of Medicine & Dentistry at the University of Alberta.

Carmel Montgomery

Carmel Montgomery, PhD, RN, has been an assistant professor in the Faculty of Nursing at the University of Alberta since 2021. She completed her PhD with the Department of Critical Care Medicine at the University of Alberta following several years of working as a staff nurse in the intensive care unit, palliative home care, quality improvement, and patient safety.


Carlsson, N., Bremer, A., Alvariza, A., Årestedt, K., & Axelsson, L. (2022). Losing a close person following death by sudden cardiac arrest: Bereaved family members’ lived experiences. Death Studies, 46(5), 1139–1148.

Clark, A. P., Guzzetta, C. E., & O’Connell, K. J. (2013). Family presence during resuscitation attempts is associated with positive psychological effects for the observers. BMJ Mental Health, 16(3), 78–78.

Cole, R., Stone, M., Keene, A. R., & Fritz, Z. (2021). Family members, ambulance clinicians and attempting CPR in the community: The ethical and legal imperative to reach collaborative consensus at speed. Journal of Medical Ethics, 47(10), 650–653.

Davidson, J. E., & Harvey, M. A. (2016). Patient and family post–intensive care syndrome. AACN Advanced Critical Care, 27(2), 184–186.

De Stefano, C., Normand, D., Jabre, P., Azoulay, E., Kentish-Barnes, N., Lapostolle, F., Baubet, T., Reuter, P.-G., Javaud, N., Borron, S. W., Vicaut, E., & Adnet, F. (2016). Family presence during resuscitation: A qualitative analysis from a national multicenter randomized clinical trial. PLOS One, 11(6), Article 6.

Douma, M. J., Graham, T. A. D., Ali, S., Dainty, K. N., Bone, A., Smith, K. E., Dennet, L., Brindley, P. G., Kroll, T., & Frazer, K. (2021). What are the care needs of families experiencing cardiac arrest?: A survivor and family led scoping review. Resuscitation, 168, 119–141.

Doyle, C. J., Post, H., Burney, R. E., Maino, J., Keefe, M., & Rhee, K. J. (1987). Family participation during resuscitation: An option. Annals of Emergency Medicine, 16(6), 673–675.

Edwardsen, E. A., Chiumento, S., & Davis, E. (2002). Family perspective of medical care and grief support after field termination by emergency medical services personnel: A preliminary report. Prehospital Emergency Care, 6(4), 440–444.

Gabbie, S., Man, K., Morgan, G., & Maity, S. (2021). The development of a family liaison team to improve communication between intensive care unit patients and their families during the COVID-19 pandemic. Archives of Disease in Childhood – Education and Practice, 106(6), 367–369.

Gordon, J., Sheppard, L. A., & Anaf, S. (2010). The patient experience in the emergency department: A systematic synthesis of qualitative research. International Emergency Nursing, 18(2), 80–88.

Heart and Stroke. (2022, May 4). Caregiver support. Heart and Stroke Foundation of Canada.

Hoek, A. E., Anker, S. C. P., van Beeck, E. F., Burdorf, A., Rood, P. P. M., & Haagsma, J. A. (2020). Patient discharge instructions in the emergency department and their effects on comprehension and recall of discharge instructions: A systematic review and meta-analysis. Annals of Emergency Medicine, 75(3), 435–444.

Holm, M. S., Norekvål, T. M., Fålun, N., & Gjengedal, E. (2012). Partners’ ambivalence towards cardiac arrest and hypothermia treatment: A qualitative study. Nursing in Critical Care, 17(5), 231–238.

Hung, M. S. Y., & Pang, S. M. C. (2011). Family presence preference when patients are receiving resuscitation in an accident and emergency department. Journal of Advanced Nursing, 67(1), 56–67.

Illum, C. (2012). The hypothermia treated patient. A qualitative study of the experiences of spouses of intensive care hypothermia treated patients. European Heart Journal. Acute Cardiovascular Care, 1(1_suppl), 87–88.

Jabre, P., Belpomme, V., Azoulay, E., Jacob, L., Bertrand, L., Lapostolle, F., Tazarourte, K., Bouilleau, G., Pinaud, V., Broche, C., Normand, D., Baubet, T., Ricard-Hibon, A., Istria, J., Beltramini, A., Alheritiere, A., Assez, N., Nace, L., Vivien, B., … Adnet, F. (2013). Family presence during cardiopulmonary resuscitation. New England Journal of Medicine, 368(11), 1008–1018.

Jampel, H. (2020, May 28). Connect with other survivors and families. Sudden Cardiac Arrest Foundation.

Jang, K., & Choe, K. (2019). Bereavement experiences after the unexpected death of an older family member in the emergency department. International Emergency Nursing, 42, 7–11.

Keyes, K. M., Pratt, C., Galea, S., McLaughlin, K. A., Koenen, K. C., & Shear, M. K. (2014). The burden of loss: Unexpected death of a loved one and psychiatric disorders across the life course in a national study. American Journal of Psychiatry, 171(8), 864–871.

King, J., O’Neill, B., Ramsay, P., Linden, M. A., Darweish Medniuk, A., Outtrim, J., & Blackwood, B. (2019). Identifying patients’ support needs following critical illness: A scoping review of the qualitative literature. Critical Care, 23(1), 187.

Kirby, K., Caswell, K., Petheram, J., Hyde, P., & Crouch, R. (2022). Mapping the patient and family liaison role in UK helicopter emergency medical services: A service evaluation. Air Medical Journal, 41(5), 458–462.

Larsson, I.-M., Wallin, E., Rubertsson, S., & Kristoferzon, M.-L. (2013). Relatives’ experiences during the next of kin’s hospital stay after surviving cardiac arrest and therapeutic hypothermia. European Journal of Cardiovascular Nursing, 12(4), 353–359.

Leske, J. S., McAndrew, N. S., & Brasel, K. J. (2013). Experiences of families when present during resuscitation in the emergency department after trauma. Journal of Trauma Nursing, 20(2), 77.

Loch, T., Drennan, I. R., Buick, J. E., Mercier, D., Brindley, P. G., MacKenzie, M., Kroll, T., Frazer, K., Douma, M. J., Ali, S., Early, S., Ruether, K., Flanary, K., Smith, K. E., Dainty, K. N., Graham, T. A. D., Graham, S. Z. A., Blomheart, L., Blommaert, J., … Family Centred Cardiac Arrest Care Project. (2023). Caring for the invisible and forgotten: A qualitative document analysis and experience-based co-design project to improve the care of families experiencing out-of-hospital cardiac arrest. Canadian Journal of Emergency Medicine, 25(3), 233–243.

Mawer, C. (2019). How can we make out-of-hospital CPR more family centered? AMA Journal of Ethics, 21(5), 461–469.

Maxton, F. J. (2008). Parental presence during resuscitation in the PICU: The parents’ experience. Journal of Clinical Nursing, 17(23), Article 23.

McGahey-Oakland, P. R., Lieder, H. S., Young, A., & Jefferson, L. S. (2007). Family experiences during resuscitation at a children’s hospital emergency department. Journal of Pediatric Health Care, 21(4), 217–225.

Oczkowski, S. J., Mazzetti, I., Cupido, C., & Fox-Robichaud, A. E. (2015). The offering of family presence during resuscitation: A systematic review and meta-analysis. Journal of Intensive Care, 3(1), 41.

Oczkowski, S. J., Mazzetti, I., Cupido, C., Fox-Robichaud, A. E., & Canadian Critical Care Society. (2015). Family presence during resuscitation: A Canadian Critical Care Society position paper. Canadian Respiratory Journal, 22(4), 201–205.

Othman, E. H., Omar, S. A., Abualruz, H., & Safadi, R. (2020). An Islamic cultural perspective of family presence during resuscitation. Resuscitation, 151, 75–76.

Perman, S. M., Siry, B., Reich, J. A., Abella, B. S., Daugherty, S. L., & Havranek, E. P. (2018). Family member perceptions of decision-making for comatose survivors of cardiac arrest. Circulation, 138(Suppl_2), A136–A136.

Redley, B., Beanland, C., & Botti, M. (2003). Accompanying critically ill relatives in emergency departments. Journal of Advanced Nursing, 44(1), 88–98.

Redley, B., Phiri, L. M., Heyns, T., Wang, W., & Han, C.-Y. (2019). Family needs during critical illness in the Emergency Department: A retrospective factor analysis of data from three countries. Journal of Clinical Nursing, 28(15–16), 2813–2823.

Rowe, B. H., McRae, A., & Rosychuk, R. J. (2020). Temporal trends in emergency department volumes and crowding metrics in a western Canadian province: A population-based, administrative data study. BMC Health Services Research, 20(1), 356.

Sawyer, K. N., Camp-Rogers, T. R., Kotini-Shah, P., Del Rios, M., Gossip, M. R., Moitra, V. K., Haywood, K. L., Dougherty, C. M., Lubitz, S. A., Rabinstein, A. A., Rittenberger, J. C., Callaway, C. W., Abella, B. S., Geocadin, R. G., Kurz, M. C., & American Heart Association Emergency Cardiovascular Care Committee; Council on Cardiovascular and Stroke Nursing; Council on Genomic and Precision Medicine; Council on Quality of Care and Outcomes Research; and Stroke Council. (2020). Sudden cardiac arrest survivorship: A scientific statement from the American Heart Association. Circulation, 141(12), e654–e685.

Schmidt, T. A., & Harrahill, M. A. (1995). Family response to out-of-hospital death. Academic Emergency Medicine, 2(6), 513–518.

Steffen, E. M., Timotijevic, L., & Coyle, A. (2020). A qualitative analysis of psychosocial needs and support impacts in families affected by young sudden cardiac death: The role of community and peer support. European Journal of Cardiovascular Nursing, 19(8), 681–690.

Stewart, S. A. (2019). Parents’ experience during a child’s resuscitation: Getting through it. Journal of Pediatric Nursing: Nursing Care of Children and Families, 47, 58–67.

Tíscar-González, V., Gastaldo, D., Moreno-Casbas, M. T., Peter, E., Rodriguez-Molinuevo, A., & Gea-Sánchez, M. (2019). [Presencia de familiares durante la reanimación cardiopulmonar: Perspectivas de pacientes, familiares y profesionales de la salud en el País Vasco] Presence of relatives during cardiopulmonary resuscitation: Perspectives of health professionals, patients and family in the Basque Country. Atención Primaria, 51(5), 269–277.

Toronto, C. E., & LaRocco, S. A. (2019). Family perception of and experience with family presence during cardiopulmonary resuscitation: An integrative review. Journal of Clinical Nursing, 28(1–2), 32–46.

Twibell, R. S., Craig, S., Siela, D., Simmonds, S., & Thomas, C. (2015). Being there: Inpatients’ perceptions of family presence during resuscitation and invasive cardiac procedures. American Journal of Critical Care, 24(6), e108–e115.

Vanhoy, M. A., Horigan, A., Stapleton, S. J., Valdez, A. M., Bradford, J. Y., Killian, M., Reeve, N. E., Andrea Slivinski, Zaleski, M. E., Jean Proehl, Wolf, L., Delao, A., & Gates, L. (2017). Clinical practice guideline: Family presence during invasive procedures and resuscitation (Revised: ed.). Emergency Nurses Association.

Weslien, M., Nilstun, T., Lundqvist, A., & Fridlund, B. (2005). When the unreal becomes real: Family members’ experiences of cardiac arrest. Nursing in Critical Care, 10(1), Article 1.

Wyckoff, M. H., Singletary, E. M., Soar, J., Olasveengen, T. M., Greif, R., Liley, H. G., Zideman, D., Bhanji, F., Andersen, L. W., Avis, S. R., Aziz, K., Bendall, J. C., Berry, D. C., Borra, V., Böttiger, B. W., Bradley, R., Bray, J. E., Breckwoldt, J., Carlson, J. N., … West, R. L. (2022). 2021 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations: Summary from the basic life support; advanced life support; neonatal life support; education, implementation, and teams; first aid task forces; and the COVID-19 working group. Circulation, 145(9).




How to Cite

Douma, M., Picard, C., Su, K., Myhre, C., Smith, K., & Montgomery, C. (2023). Clinician’s Corner: Meeting family care needs during resuscitative procedures and cardiac arrest in the emergency department. Canadian Journal of Emergency Nursing, 46(1), 14–18.



Peer Reviewed Articles