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

  • 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.

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) health care team to deliver quality medical care and acknowledge and address psychosocial and spiritual care for parents, siblings, and family members throughout the treatment.

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 health care team who may witness multiple traumatic and unexpected deaths of children over the course of their professional careers. Health care 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.

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 on death and dying; especially how to tell parents their child has died.

The American Academy of Pediatrics (AAP), American College of Emergency Physicians (ACEP), and the Emergency Nurses Association (ENA) collaborated to develop a policy statement1,2 and technical report.3,4

The AAP, ACEP, and ENA support the following principles:

  • The ED health care team uses a patient-centered, family-focused, and team-oriented approach when a child dies in the ED.

  • The ED health care team provides personal, compassionate, and individualized support to families while respecting social, spiritual, and cultural diversity.

  • The ED health care team provides effective, timely, attentive, and sensitive palliative care to patients with life span–limiting conditions and ...

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