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High-Yield Facts

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  • The death of a child in an emergency department (ED) has profound effects on physicians as well as surviving family members.

  • The language used when telling parents their child is dead should be direct and nonjudgmental.

  • Parents and family members should be offered an opportunity to hold and spend time with their child after the death.

  • Immediate notification of an organ donation authority is required.

  • Most cases of unexplained pediatric deaths require an autopsy.

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Introduction

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The death of a child is likely the most tragic and devastating event any parent can experience. The sudden and unexpected death of a child is life-changing and its impact on the parents, siblings, and other family members is significant. They may have little or no time to say “goodbye” or “I love you” to their child and they may have to explain to other children about the death of their sibling. It is the responsibility of the emergency department (ED) healthcare team to deliver quality medical care and acknowledge and address psychosocial and spiritual care for parents, siblings, and family members throughout the treatment.

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The death of a child in the ED may have a profound effect on those caring for the child as well. Informing parents and family members of their child's death impacts the entire healthcare team who may witness multiple traumatic and unexpected deaths of children over the course of their professional careers. Healthcare providers have to put their own feelings aside to care for the patient, and offer emotional support for the parents and family members. It may be minutes or hours later before the death of a child has an impact upon them and they are afforded time to deal with their own feelings.

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Emergency physicians may feel guilty or inadequate after a failed resuscitation, even when they know the child had little to no chance of survival. This feeling may linger throughout the remainder of their entire shift and impact their ability to focus on the care of other patients. Emergency physicians often lack formal training in how to deliver bad news to families or death and dying; especially how to tell parents their child has died.

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Patient- and Family-Centered Care and Parental Presence During Resuscitation

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Physicians are looked to as the healthcare team leader and bear responsibility for involving the family in decisions and delivering bad news. In the scenario of an acute resuscitation the physician may not be immediately available to the parents or only intermittently available. Another member of the healthcare team should be available to the family to provide emotional and spiritual support as needed. Due to lack of prior relationships, limited training of physicians, and the unexpectedness of childhood death, it is crucial to include personnel skilled in identifying and addressing the psychosocial and spiritual aspects that arise during the course of these devastating ...

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