How EMS can avoid misinterpretation by engaging with family members

Early in any cardiac resuscitation, begin communication with a family representative and assume all actions and words are being recorded

Act, react, adapt and overcome. And be careful what you say.

I think that is the lesson coming out of this news story where the words of the EMS provider may have been misinterpreted by the family, causing everyone some level of heartache, grief and frustration.

To be certain, in a cardiac arrest time is essential, and the pressure to execute well can cause stress to rise. That’s exactly the moment when EMS providers need to be at their most professional and most aware self. One can imagine the grief the family must feel while the resuscitation is in progress and how that might cause them to misinterpret what was said or done.

We can improve communication during a cardiac arrest resuscitation situation in two ways. First, make sure someone connects with the family right away and stays connected throughout the incident. Explaining procedures and possible outcomes in “real time” can help the family better understand what’s happening to their loved one. The communication and trust building that comes with it might better prepare the family to receive and handle the impending bad news. Communication makes the management of a stressful situation more transparent to those not familiar with medical interventions.

Second, be very conscious about what you say, and what others might say, during the incident. Mobile recording devices are ubiquitous. In many situations people can make video or audio recordings legally. As this article points out, we carry medical equipment that also records every sound being made. What these devices don’t do, however, is capture context - what was happening while the sounds were being recorded.

Recent videos of police shootings, filmed by bystanders, are prime examples of how “unclear" video can be. Be clear in what you say and provide context whenever possible. I know of crews who call out each time a procedure is accomplished, as to have it recorded by the monitor. I also know of crews who will discreetly request additional backup in case of equipment failure.

In this incident it sounds like the on-scene medic adapted correctly by manually inserting the needle when the drill failed. There are several options to overcome an equipment issue, and ways to describe them to observers.

Paying attention to what you say (or do) may be annoying, but worth the effort. Despite the unlikelihood of liability in this case, it seems clear that there will be a lot of headaches coming down the road for the EMS crew who was on scene that morning. Hopefully it will resolve without a legal proceeding.

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