Source:Boie ET, Moore GP, Brummett C, Nelson DR. Do parents want to be present during invasive procedures performed on their children in the emergency department? A survey of 400 parents.
Ann Emerg Med.
1999
;
34
:
70
–74.

During a 10-week period, parents and grandparents in the ED waiting area of a large Indianapolis inner-city university hospital were given a self-administered written survey containing five scenarios involving treatment of their child with procedures. Participants were not required to have an ill child with them that day and were invited to participate regardless of their age or the age of their children. The scenarios involved procedures of increasing degree of invasiveness: (1) venipuncture, (2) laceration repair, (3) lumbar puncture, (4) oral endotracheal intubation, and (5) major resuscitation. In the major resuscitation scenario, the caretaker was asked whether they would want to stay with their child if their child was (a) awake, (b) unconscious or (c) likely to die. In all cases a description and diagram of the procedure were included.

Four hundred (98%) of the eligible caretakers completed the survey. The vast majority preferred to be present during all procedures, although there appeared to be a general trend of decreased desire to be present as procedural invasiveness increased: venipuncture (98%), laceration (94%), lumbar puncture (87%), endotracheal intubation (81%). For the resuscitation scenario, 81% of caretakers preferred to be present if the child was awake, 71% if the child was unconscious, and 83% if the child was likely to die. Only 6.5% of those surveyed wanted the physician to determine parental presence in all 5 scenarios.

There are some limitations with any survey tool. For example, in this study brief descriptions cannot adequately describe the experience of “being there.” A parent’s desire to be present during a procedure may seem like a good idea until they actually see their child and hear them screaming. Furthermore, the scenarios were not presented in random order and therefore do not take into account potential participant fatigue with the later cases. Nevertheless, these data add to a growing body of evidence describing a parental preference for being involved in all phases of their child’s care.1–,4 The custom of asking parents to “wait outside” while procedures were done on their child was based, in part, on the belief that children should not associate their parents with the pain of a procedure. More often than not, parental absence made the procedure less stressful for the physician and nurse but probably not for the parent or the child. As most hospitals move toward “family-centered care,” it would behoove us to increase the parental role in both decision-making and care of their children. We often underestimate parents’ ability to handle the complexities and complications involved in supporting their child during a painful procedure. Only under the most extraordinary circumstances should we deny parents the right to be with their child, especially if their child is likely to die. Our policies and procedures should help parents...

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