Interstate pedestrian crossing: a form of self-destructive behavior?

Emotional conflicts, malassociation with peers, and inadequate family support are not the emergency physician's primary considerations when attending a severely traumatized child. This report makes an appeal for the clinician to determine the sequence of events that preceded the trauma. Attempts should be made to distinguish between intentional and accidental trauma by viewing the event, not in isolation, but rather in the context of potential environmental stress affecting the child and family. Among the multidisciplinary coalition we forge to provide ongoing care for the trauma patient, there should be a mental health specialist. Exploration for family discord, escalating stress, and suicidal ideation should become central themes for emergency physicians who treat traumatized children.