Surrogate consent by family members for out-of-hospital cardiac arrest research

Objectives: To evaluate the availability of family members of potential sub jects to provide consent for participation in out-of-hospital cardiac arres t (OOHCA) research and to estimate the time required to contact a family me mber. Methods: This study was a prospective observational study of adult pa tients (> 18 years old) with nontraumatic OOHCA treated by an urban emergen cy medical service. Emergency medicine resident physicians responded to eac h scene and noted the presence of family members. A subsequent convenience sample of family members answered standardized questions about their abilit y to provide consent for research participation on behalf of the patient. R esults: Physicians were present at 100 of the 112 adult medical cardiac arr ests during the study period. A family member was present at 57% of the sce nes (95% CI = 47% to 67%). Patients with family present were older and were less likely to have bystander cardiopulmonary resuscitation (CPR) or live in a nursing home. The mean time (+/- SE) from emergency dispatch to family contact was 24.40 (+/-2.60) minutes and from physician arrival to family c ontact was 2.45 (+/-0.87) minutes (n = 20). Eight of 13 family members were willing to enroll the patient into a resuscitation study, but five family members were unable to understand the explanation of informed consent. Conc lusions: Family members were present for an unrepresentative subset of OOHC A cases, and were contacted after the therapeutic window for many intervent ions. The emotional nature of the emergency situation also limited the reli ability of surrogate consent for OOHCA research.