Department of Surgery, University of California, San Francisco East Bay, Oakland, CA USA.
Department of Pediatrics, Lundquist Institute at Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA USA.
J Pediatr Surg. 2021 Dec;56(12):2348-2353. doi: 10.1016/j.jpedsurg.2021.03.009. Epub 2021 Mar 18.
Trauma patients undergo a standardized history and physical, however identification of mental health risk factors is not typically included. We aimed to assess the feasibility of using a modified version of Psychological Simple Triage and Rapid Treatment (PsySTART) to identify post-traumatic stress disorder (PTSD) risk factors in pediatric trauma patients. We hypothesized that PsySTART could identify risk factors and be integrated into the electronic medical record (EMR).
Trauma patients 10-17 years old at a level II pediatric trauma center from 2014 to 2015 were screened. PsySTART was used on a pilot cohort to determine if risk factors were present. PsySTART was then integrated into an automated EMR workflow and completion rates were evaluated.
PsySTART was completed in a pilot cohort of 63 patients with the following findings: 33.3% (n = 21) with 1 risk factor, 22.2% (n = 14) with 2 risk factors, and 19.1% (n = 12) with ≥3 risk factors. The most commonly identified risk factor was, "felt or expressed extreme fear or panic" (n = 27, 43.0%). After EMR integration, PsySTART was successfully completed with automatic consults in 156 of 198 patients (78.8%).
PsySTART identified risk factors in pediatric trauma patients. EMR integration was feasible and led to proactive psychological management and intervention.
IV.
创伤患者接受标准化的病史和体格检查，但通常不包括心理健康风险因素的识别。我们旨在评估使用修改后的心理简易分诊和快速治疗（PsySTART）来识别儿科创伤患者创伤后应激障碍（PTSD）风险因素的可行性。我们假设 PsySTART 可以识别风险因素并整合到电子病历（EMR）中。
2014 年至 2015 年，在二级儿科创伤中心对 10-17 岁的创伤患者进行了筛选。在试点队列中使用 PsySTART 确定是否存在风险因素。然后，PsySTART 被整合到自动化 EMR 工作流程中，并评估了完成率。
PsySTART 在 63 名试点队列患者中完成，结果如下：33.3%（n=21）有 1 个风险因素，22.2%（n=14）有 2 个风险因素，19.1%（n=12）有≥3 个风险因素。最常见的风险因素是“感到或表达极度恐惧或恐慌”（n=27，43.0%）。在 EMR 整合后，在 198 名患者中的 156 名（78.8%）成功完成了 PsySTART 自动咨询。
PsySTART 确定了儿科创伤患者的风险因素。EMR 整合是可行的，并导致了主动的心理管理和干预。
IV。
