Views & Reviews Personal View

We still lack patient centered visitation in intensive care units

BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h792 (Published 11 February 2015) Cite this as: BMJ 2015;350:h792
  1. Samuel M Brown, director, Center for Humanizing Critical Care, Intermountain Medical Center, 5121 South Cottonwood Street, Murray, UT 84107, USA, and assistant professor, pulmonary and critical care medicine, University of Utah School of Medicine
  1. samuel.brown{at}imail.org

Weak and paternalistic arguments are still being used to restrict family visits to patients in intensive care, writes Samuel M Brown

Tom, my friend’s father, unexpectedly had a cardiac arrest at age 68. Flash pulmonary edema spiraled out of control in the ambulance as it rushed him to the hospital. Although chest compressions and intravenous epinephrine (adrenaline) restored his circulation, Tom then lay for three days in the agonizing uncertainty of coma after cardiac arrest.

Despite some hope from therapeutic hypothermia,1 2 we physicians at the intensive care unit (ICU) are mostly powerless to treat neurological injury after cardiac arrest. So we wait our three days, hoping that closed eyes will open again. We join families in a desperate, powerless yearning that these patients will once more speak and think and love.

I couldn’t find words for my anger when my friend called to explain that hospital policy barred Tom’s wife and children from his bedside as he lay, comatose, in hospital. No more than two visitors for 20 …

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