Is Pediatric Intensive Care Trauma-Informed? A Review of Principles and Evidence

Lauren A Demers1,2, Naomi M Wright2,3, Avi J Kopstick4

  • 1Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR 97239, USA.

Insights

Trauma-informed care (TIC) in Pediatric Intensive Care Units (PICUs) can improve care for critically ill children. Implementing TIC principles helps mitigate distress and supports better recovery for children and families.

Area of Science:

  • Pediatric critical care medicine
  • Child trauma and resilience
  • Healthcare quality improvement

Background:

  • Pediatric critical illness and recovery are potentially traumatic for children and families.
  • Children in Pediatric Intensive Care Units (PICUs) may have pre-existing trauma, increasing vulnerability to distress.
  • Trauma-informed care (TIC) in PICUs is under-examined but shows potential for enhancing care quality and patient outcomes.

Purpose of the Study:

  • To describe the need for implementing trauma-informed care (TIC) in Pediatric Intensive Care Units (PICUs).
  • To introduce the American Academy of Pediatrics' principles of TIC: awareness, readiness, detection and assessment, management, and integration.
  • To review current clinical practices within PICU settings related to each TIC principle.

Main Methods:

  • This paper utilizes a narrative review methodology.
  • It examines the existing literature on trauma and critical care in pediatric populations.
  • Current clinical practices in PICUs are analyzed against established TIC principles.

Main Results:

  • The review highlights the significant need for trauma-informed care (TIC) in Pediatric Intensive Care Units (PICUs).
  • Current clinical practices are assessed in relation to the five core principles of TIC.
  • Opportunities for enhancing TIC programs to improve patient care and advance scientific knowledge are identified.

Conclusions:

  • Trauma-informed care (TIC) is essential for improving the quality of care and mitigating trauma-related symptoms in Pediatric Intensive Care Units (PICUs).
  • Further development and integration of TIC programs are recommended to better support children and families during critical illness and recovery.
  • Implementing TIC principles can lead to more positive coping mechanisms and better anticipatory guidance for the recovery process.

Related Concept Videos

Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
40
Standards of Care II01:19

Standards of Care II

Nurses bear specific legal responsibilities under several federal statutes, including:
714
Standards of Care I01:22

Standards of Care I

Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:
750
Nursing Ethical Principles II01:27

Nursing Ethical Principles II

Ethical principles are essential in guiding nurses to fulfill their responsibilities, focusing on the quality of nursing care and decision-making. These principles, including autonomy, beneficence, non-maleficence, justice, and fidelity, shape the ethical framework within healthcare settings.
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
1.1K
Nursing Ethical Principles I01:22

Nursing Ethical Principles I

Ethical principles serve as the moral compass in the longstanding tradition of nursing, guiding healthcare professionals in their interactions with patients and families. These principles, namely autonomy, beneficence, non-maleficence, justice, and fidelity, provide a robust framework for navigating the ethical complexities of daily nursing practice.
Autonomy
Autonomy underscores the significance of a patient's self-determination and freedom from external control. In healthcare, respecting...
1.9K
Interdisciplinary Care: The Health Care Team-I01:21

Interdisciplinary Care: The Health Care Team-I

An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care.
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
1.7K