FAMILY RESPONSE TO OUT-OF-HOSPITAL DEATH

Objective: To better understand the perceptions, needs, and responses of family members after an out-of-hospital death. Methods: Over an 18- month period, phone interviews were conducted using a structured inter view schedule modified from a similar study of survivors of in-hospita l death. Subjects included 31 survivors of urban out-of-hospital death s attended by paramedics from one ambulance company. Subjects were eli gible if paramedics had arrived and death had been determined at the s cene without transport. Survivors were interviewed 11 to 15 months aft er the death (mean = 12 months) to evaluate how well they coped with t heir loss, how they managed the experience of their loved ones' out-of -hospital deaths, and their feelings and beliefs about their loved one s' not being transported to a hospital. Results: None of the survivors believed their loved ones should have been transported to a hospital, and only one believed that something more could have been done for th e individual. Although many of the. survivors had suspected their love d ones had died, 64% had been informed of the death by emergency medic al technicians (EMTs) or firefighters. Most thought the EMTs had infor med them in a professional (81%) and gentle/supportive manner (74%). S ome (29%) still had unanswered questions about the death, but most (58 %) were adjusting well and no one had a ''poor'' adjustment. Conclusio n: In this small sample, survivors of out-of-hospital death were gener ally satisfied with the care their loved ones had received. None of th e survivors believed their loved ones should have been transported to the hospital. They also believed the paramedics had been supportive an d met their needs at the time of death. It appears that paramedics may be able to meet the needs of a patient's survivors by terminating out -of-hospital resuscitation efforts on the patient.