Family presence during out-of-hospital cardiopulmonary resuscitation

6Health care providers' attitude towards family members during cardiopulmonary resuscitation (CPR) remains highly debated. Recent results from the "PRESENCE" clinical trial show a beneficial effect of offering the family the opportunity to observe CPR in terms of post-traumatic stress disorder and symptoms of anxiety and depression. In addition, family presence does not interfere with medical efforts, increase stress in the health care team, or result in medicolegal conflicts. This study increases the level of evidence of international guidelines for cardiac arrest management that, since 2005, advocated allowing the presence of relatives during CPR. This strategy should be guided by a well-defined protocol, a designated support assistant charged with carefully explaining the resuscitative efforts and prior training of medical staff. Future studies should aim to improve our understanding of why the presence of family members during CPR may reduce their suffering and in what kind of health system such an approach could be implemented in practice in a safe and cost-effective manner.