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Perspectives on Care at the Close of Life
June 14, 2006

Sudden Traumatic Death in Children: “We Did Everything, but Your Child Didn't Survive”

Author Affiliations

Author Affiliations: Division of Critical Care Medicine, Children's Hospital Boston (Drs Truog and Meyer), Departments of Social Medicine (Dr Truog) and Psychiatry (Dr Meyer), Harvard Medical School, Boston, Mass; Columbia University School of Social Work, New York, NY (Dr Christ); and Initiative for Pediatric Palliative Care, Education Development Center, Inc, Boston, Mass (Mr Browning).

JAMA. 2006;295(22):2646-2654. doi:10.1001/jama.295.22.2646

When caring for children who become suddenly and catastrophically ill, clinicians must simultaneously attend to a complex and rapidly evolving medical situation, as well as to the equally challenging demands of establishing compassionate relationships with family members and communicating well with colleagues. An 18-month-old toddler was brought to the hospital with severe head injury after being struck by a car. Over a period of hours, her condition evolved from prognostic uncertainty to the diagnosis of brain death and considerations of organ donation. Against this medical backdrop, the clinicians successfully established a trusting relationship with family members by careful attention to their emotional, informational, and care needs as they absorbed the devastating prognosis, took in the results of the brain death examination, and considered the option of organ donation. This case illustrates the importance of interdisciplinary communication, the vital role of social workers and other psychosocial providers with expertise in working with families, and the critical significance of mutual care and support for the clinicians who accompany families through these tragic life events.

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