II. Epidemiology
- Incidence (U.S.): 40,000 childhood deaths per year
III. Approach: General
- State it simply, succinctly and in plain language
- Example: "We could not save <name> and they have died. I am very sorry."
- Example: "<name> was dead on arrival to the Emergency Department. I am very sorry"
- Avoid additional commentary beyond above
- But come prepared, knowing the patient's name, and all information regarding the event and Resuscitation
- Focus on answering family's questions truthfully
- Match the response to the level of detail that is asked
- Avoid medical jargon
- Do not avoid contact with the family
- When to leave the room is a judgment call (but warm hand-off family to another staff member)
- Allow for memory items (hand or foot mold, lock of hair, or jewelry)
- Some items may be required to remain until after any planned post-mortem evaluation (e.g. coroner)
- Allow parents to hold their deceased child if they wish (unless it interferes with investigation)
- Allow family to be present at Resuscitation if they wish
- Typically hospital staff member is assigned to accompany them
- Assigned staff are there to answer questions they have during the Resuscitation
- Do not give advice
- Do not use phrases of "being in better place, or no longer suffering"
- Family may say this, but providers should refrain from this
- Brochures on support services may be given
- However avoid extensive counseling on this initially as parent's will not retain this
- Do not use phrases of "being in better place, or no longer suffering"
IV. Resources
- Compassionate Friends
- Bereaved Parents USA
V. References
- Majoewsky (2013) EM:Rap 13(5):3-4
- Wender (2012) Pediatrics 130(6): 1164-9 [PubMed]