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Initial distress among children and families in medical settings is common, expected, and understandable. Many families cope well, with support and with time. However, some may develop persistent traumatic stress reactions, which can impede health and psychosocial functioning.

What is Pediatric Medical Traumatic Stress?

Pediatric medical traumatic stress is a constellation of reactions that can occur after extremely difficult or frightening events. These reactions include:

  • having unwanted and intrusive thoughts about what happened,
  • strongly avoiding things that are reminders of the event, and
  • having trouble sleeping, eating, or concentrating.

In the aftermath of a potentially traumatic event, traumatic stress is caused by a loss of a sense of personal safety, and by feelings of fear and helplessness.

Children are especially vulnerable to the loss of safety that a traumatic event can bring:

  • They look to adults for information and comfort during a traumatic event.
  • To judge danger, they look to cues from adults and the environment. They may misinterpret cues (e.g. blood, sirens, parents’ visible upset) and over-estimate danger and life threat.
  • Younger children are not able to understand many aspects of events, and they may express fear and distress through behavior rather than words.

All of these factors can lead to pediatric medical traumatic stress in children. 

Risk Factors for Pediatric Medical Traumatic Stress

Key risk factors in the development of pediatric medical traumatic stress in children: perceived trauma severity and life threat.

Medical events and medical settings can be traumatic, especially when children and families have to face:

  • Sudden or serious illness or injury
  • Painful or frightening treatment procedures
  • Sights, sounds, or experiences in the hospital or emergency department that are new or frightening

By incorporating an awareness of pediatric medical traumatic stress in their encounters with children and families, health care providers can:

  • Minimize potentially traumatic aspects of medical care
  • Identify children and families at higher risk for persistent distress
  • Prevent long-term traumatic stress reactions