Scratching Below The Surface: Screening For Posttraumatic Stress Symptoms Following Hospitalization With Trauma Service
*Virginia D Cline, *Brian Whitaker, Petra A Duran, *Kelly Ratcliff, Eric H. Rosenfeld, *Bindi Naik-Mathuria
BCM/TCH, Houston, TX
Background (issue):While many youth adjust well, post-traumatic stress disorder (PTSD) occurs in 13-35% of children with traumatic injuries, and is associated with many negative outcomes. When not actively screened for, PTSD can be missed by trauma providers. Our institution implemented a screening program to identify which trauma patients need more targeted evaluation services.
Methods:Retrospective review of PTSD screening for pediatric patients discharged from a level I pediatric trauma center (5/2015-1/2017). Patients were screened at least 2 weeks following discharge in the outpatient pediatric surgery trauma clinic using The Child Trauma Screening Questionnaire or the Young Child PTSD Screen. Referrals to the Pediatric Health Psychology Program were made for positive screens.
Findings:Of 881 trauma activations, 31 (4%) patients were screened, with nine positive screens (29%). The most common injury mechanism was automobile versus pedestrians (3/9, 33%), and younger patients were at higher risk for PTSD (6.0 ± 5.3 vs 11.6 ±4.4, p=0.02). Seven patients (78%) with positive screens and two patients with screening form issues were referred to psychology. Four (44%) of these nine patients arrived for/have scheduled a psychology evaluation.
Conclusions (implications for practice):The PTSD screening process identified patients for whom evaluation and intervention has been possible; however, a significant number of patients are not screened after discharge, when symptoms of traumatic stress are likely to emerge. Therefore, we will be implementing an automated email-based program with electronic PTSD screening. This project is an example of the opportunity for collaboration between medical and behavioral health specialties to meet the American Academy of Pediatric’s call to reduce stress among children.
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