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[The injured child in the intensive care unit (author's transl)]
Insights
Intensive care units (ICUs) can cause psychological stress in children. A pseudo-apallic syndrome, mimicking a coma, can arise from traumatic unconsciousness in the ICU, requiring specific staff interventions.
Area of Science:
- Pediatric Psychology
- Intensive Care Medicine
- Psychotraumatology
Background:
- Intensive care unit (ICU) environments pose significant psychological stress for pediatric patients.
- Children awakening to consciousness within an ICU after traumatic unconsciousness face extreme psychological duress.
- Such extreme situations can precipitate abnormal psychic emergency reactions in children.
Observation:
- The study discusses the factors contributing to a primitive psychic reaction in children within the ICU.
- This reaction can manifest as a "fainting-death reflex," clinically resembling a coma vigile or apallic state.
- A case study illustrates the clinical presentation, progression, and management of this pseudo-apallic syndrome, also termed "Sleeping Beauty syndrome."
Findings:
- The pseudo-apallic syndrome is a recognized, albeit rare, psychological emergency reaction in critically ill children.
- Clinical manifestations, disease course, and treatment strategies for this syndrome are presented through a case example.
- The syndrome can mimic a coma but is a reactive state rather than a true neurological deficit.
Implications:
- Understanding and recognizing the pseudo-apallic syndrome is crucial for pediatric ICU staff.
- Early identification and appropriate intervention by ICU staff are vital for managing this reactive disturbance.
- The role of healthcare professionals in preventing and treating this syndrome in children is emphasized, highlighting the need for specialized training and awareness.
Abstract:
For children the circumstances of the intensive care unit (ICU) indubitably present a particular psychological stress. For a child awaking from a state of traumatic unconsciousness in the ICU, and who has to be further treated there, this is an even more powerful psychological extreme situation. Extreme situation of this kind is liable to provoke a particular abnormal psychic "emergency reaction". This reaction can follow the pattern of a faigned-death reflex and in a such a way mime a coma vigile (apallic state). The circumstances and the interaction of factors responsible for the arise of such a primitive reaction are discussed. With the help of a representative case the clinical manifestations, course and treatment of the pseudo-apallic syndrome ("Sleeping Beauty syndrome") are presented. The important role of ICU staff for the prevention and treatment of such reactive disturbances are emphasized.