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Caring for Critically Ill Children Experiencing Traumatic Stress
1Betsy M. McDowell is a pediatric nurse and retired nurse educator at Newberry College, Newberry, South Carolina.
Insights
Critically ill children may experience traumatic stress, including acute stress reaction and posttraumatic stress disorder. Nurses can help prevent and manage these conditions in pediatric patients.
Area of Science:
- Pediatric critical care
- Child psychology
- Trauma-informed nursing
Background:
- Traumatic stress affects children when coping mechanisms are overwhelmed by traumatic events.
- Up to 80% of ill and injured children may experience traumatic stress.
- Critically ill or injured children are at high risk for acute stress reaction and posttraumatic stress disorder.
Purpose of the Study:
- To explore traumatic stress disorders in critically ill or injured children.
- To aid bedside nurses in reducing short- and long-term consequences.
- To provide strategies for pediatric patients experiencing traumatic stress.
Main Methods:
- Review of literature on traumatic stress in pediatric patients.
- Identification of risk factors and clinical findings.
- Outline of nursing interventions for prevention and management.
Main Results:
- Traumatic stress is a significant concern in critically ill children.
- Early identification and intervention are crucial.
- Nurses play a vital role in assessment and management.
Conclusions:
- Bedside nurses are well-positioned to assess and manage traumatic stress in pediatric intensive care units.
- Implementing preventative and management strategies can ease symptoms.
- Appropriate referrals are essential for children and families.
Topic/Clinical Relevance:
Traumatic stress occurs in children when their coping mechanisms are overwhelmed by exposure to traumatic events or situations. Estimates indicate that as many as 80% of ill and injured children experience traumatic stress after such exposure. Critically ill or injured children are especially at risk for the development of traumatic stress, including acute stress reaction and posttraumatic stress disorder.
Objective:
To explore the phenomenon of traumatic stress disorders in critically ill or injured children to assist bedside nurses in decreasing the severity of short- and long-term consequences in this patient population.
Content Covered:
This article presents types of traumatic stress, risk factors for the development of traumatic stress, clinical findings in children and adolescents, and nursing strategies for preventing and managing traumatic stress in pediatric patients. Critical care and acute care nurses are in an excellent position to assess children for symptoms of acute stress reaction and posttraumatic stress disorder during or after a stay in the intensive care unit, to implement strategies to prevent or ease the symptoms of acute stress reaction and posttraumatic stress disorder, and to make appropriate referrals for children and their families after exposure to traumatic stressors.
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Assessment:
1. Clinical Evaluation:
History:
Traumatic Memory

