Content area
Full Text
The ABCDE approach incorporates the principles of effective death notifi cation
You, your partner, and a team of first responders have spent 30 minutes trying to bring a 38-year-old fa ther of three back to life. Unfortunately, the resuscitation was not successful. His family is in the other room waiting for word on how he is doing-you can hear sobbing and angry voices. No one from the EMS team has spoken to them about the sta tus of their loved one. It is up to you to inform his spouse and teenage children he succumbed to a presumed cardiac arrest.
Dreading the thought of breaking the bad news, you've stayed involved in patient care and put off the inevitable interaction with family. Even after time of death was established, you've continued to busy yourself by packing up equipment. Understandably, you are at a loss for why your treatments did not work. You grapple with a sense of failure. Struggling to answer your own questions, how can you answer those asked by survivors?
Telling survivors their loved one has died is the most important and difficult duty of a paramedic. The average number of death notifications a paramedic provides annually varies. Regardless of the number or frequency, it is never easy.
This difficulty lies in many causes. A paramedic may have a sense of failure, be at a loss for words or have no idea how to convey the message, be intimidated by the emotional displays of survivors, or be overwhelmed by personal experience. From an educational standpoint, there is little to no in-depth training on what to do after a resuscitation is stopped. Tradition has left learning this task to on-the-job training. Fumbling through the process is not good for paramedic or survivor.
Breaking bad news is an aspect of medicine that has been researched for decades- so much so, it has its own acronym, BBN. Researchers have compartmentalized BBN study into four categories:
* Provider discomfort/reluctance;
* Quality of message or delivery;
* Survivor wishes for how to receive news;
* Educational models.
Few BBN studies have evaluated paramedics. Instead, BBN research has focused on doctors. Physicians have to share news not only of death but also of debilitating and terminal diseases. Despite...