Ashworth Henry, Lewis-O'Connor Annie, Grossman Samara, Brown Taylor, Elisseou Sadie, Stoklosa Hanni
Department of Emergency Medicine, Alameda Health System, Highland Hospital, Oakland, CA, USA.
Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Int J Emerg Med. 2023 May 19;16(1):38. doi: 10.1186/s12245-023-00509-w.
A patient's current or previous experience of trauma may have an impact on their health and affect their ability to engage in health care. Every year, millions of patients who have experienced physically or emotionally traumatic experiences present to emergency departments (ED) for care. Often, the experience of being in the ED itself can exacerbate patient distress and invoke physiological dysregulation. The physiological reactions that lead to fight, flight, or freeze responses can make providing care to these patients complex and can even lead to harmful encounters for providers. There is a need to improve the care provided to the vast number of patients in the ED and create a safer environment for patients and healthcare workers. One solution to this complex challenge is understanding and integrating trauma-informed care (TIC) into emergency services. The federal Substance Abuse and Mental Health Service Administration's (SAMHSA) six guiding principles of TIC offer a universal precaution framework that ensures quality care for all patients, providers, and staff in EDs. While there is growing evidence that TIC quantitatively and qualitatively improves ED care, there is a lack of practical, emergency medicine-specific guidance on how to best operationalize TIC. In this article, using a case example, we outline how emergency medicine providers can integrate TIC into their practice.
患者当前或既往的创伤经历可能会对其健康产生影响,并影响他们接受医疗保健的能力。每年,数百万有身体或情感创伤经历的患者前往急诊科(ED)就诊。通常,身处急诊科本身的经历会加剧患者的痛苦,并引发生理失调。导致战斗、逃跑或冻结反应的生理反应会使为这些患者提供护理变得复杂,甚至可能给医护人员带来有害的接触。有必要改善急诊科为大量患者提供的护理,并为患者和医护人员创造一个更安全的环境。应对这一复杂挑战的一个解决方案是理解创伤知情护理(TIC)并将其融入急诊服务中。联邦药物滥用和心理健康服务管理局(SAMHSA)的TIC六项指导原则提供了一个通用的预防框架,可确保为急诊科的所有患者、医护人员和工作人员提供优质护理。虽然越来越多的证据表明TIC在数量和质量上改善了急诊护理,但对于如何最好地实施TIC,缺乏实用的、针对急诊医学的指导。在本文中,我们通过一个案例示例,概述了急诊医学提供者如何将TIC融入他们的实践中。