Until 2002, in the ED of Children’s medical Center in Dallas, we sometimes allowed families to be present at patient’s bedsides during invasive procedures (IPs, such as central line placement, lumbar puncture, and chest tube insertion) and resuscitation interventions (RIs, including emergency endotracheal intubation and cardiopulmonary resuscitation). However, we had no guidelines or policies on the presence of family-defined as relatives or significant others with whom the patient shares an established relationship-during such interventions, nor did we have any formal support from our ED administartors. In practice, we drew the line on certain procedures that we deemed too painful fro families to witness.

In 1995 the Emergency Nurses Association (ENA) developed clinical guidelines to support the option of family presence during IPs and RIs Other health organizations, including the American Heart Association (AHA) and the American Association of critical-Care Nurses, have since followed suit. In addition, advanced training programs such as the AHA’s Advanced Cardiac Life support Course and Pediatric Advance Life Support Course and the ENA’s Trauma nursing Core Course and Emergency Nursing Pediatric Course have been incorporating family presence recommendations into their curricula.

we decide that our ED should have a written policy regarding family presence. First we examined recent surveys, many of which found that the majority of family members want to be in the room while their loved ones are undergoing emergency procedures.