Family Response to Out–of–hospital Death

Objective: To better understand the perceptions, needs, and responses of family members after an out–of–hospital death. Methods: Over an 18–month period, phone interviews were conducted using a structured interview schedule modified from a similar study of survivors of in–hospital death. Subjects included 31 survivors of urban out–of–hospital deaths attended by paramedics from one ambulance company. Subjects were eligible if paramedics had arrived and death had been determined at the scene without transport. Survivors were interviewed 11 to 15 months after the death (mean = 12 months) to evaluate how well they coped with their loss, how they managed the experience of their loved ones' out–of–hospital deaths, and their feelings and beliefs about their loved ones' not being transported to a hospital. Results: None of the survivors believed their loved ones should have been transported to a hospital, and only one believed that something more could have been done for the individual. Although many of the survivors had suspected their loved ones had died, 64% had been informed of the death by emergency medical technicians (EMTs) or firefighters. Most thought the EMTs had informed them in a professional (81%) and gentle/supportive manner (74%). Some (29%) still had unanswered questions about the death, but most (58%) were adjusting well and no one had a “poor” adjustment. Conclusion: In this small sample, survivors of out–of–hospital death were generally satisfied with the care their loved ones had received. None of the survivors believed their loved ones should have been transported to the hospital. They also believed the paramedics had been supportive and met their needs at the time of death. It appears that paramedics may be able to meet the needs of a patient's survivors by terminating out–of–hospital resuscitation efforts on the patient.