You're an EMT/paramedic arriving on the scene of pediatric injury. At the scene, you find a a young child who was hit by a car. There's a crowd of friends and family around. The child is awake, but dazed and quiet. You know that: 

  • The sights and sounds of an accident scene and/or ambulance can be very frightening for children, who may overestimate life threat or seriousness of their condition
  • A child's perception of life threat can be unrelated to actual injury severity; therefore, provider's medical impressions can be different from what the child is thinking or feeling
  • Like many other children who may be in this situation, the patient is in pain, separated from his parents, and feels alone and scared

All of these factors can contribute to current traumatic stress reactions in children and potential persistent posttraumatic stress. How do you minimize the potential for future traumatic stress reactions in these situations? Do you sit or kneel down to be at the child's eye level? Or do you assess their mental status using associations they would understand, such as cartoons or TV shows? Do you show and explain to them how any equipment and tools will be used? These are all ways to help minimize traumatic stress. Other ways include:

  • Provide simple explanations about what is happening and what will happen next
  • Minimize additional exposure to traumatic elements at the scene or during transport
  • Encourage parent presence. If not possible, remember you will be viewed by the child as a surrogate parent

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