Don't forget to calm a young trauma patient

A pediatric trauma patient might come to your ED directly from the scene without any parents or family present.

"They are scared and screaming, so it is difficult to get assessments on these kids," says Carrie L. Baumann, RN, BSN, patient care supervisor in the Emergency Department Trauma Center at Children's Hospital of Wisconsin in Milwaukee. "We are all in personal protective equipment, which consists of goggles, masks, gowns, gloves. This is a very scary situation for children of all ages, with 12 people garbed up and ready to go."

To calm your pediatric trauma patient, do these three things:

  • Make your voice heard in the flurry of activity.

"Two physicians and nurses descend immediately on the patient and there is a lot of talking, says Baumann. "One person should talk to the child. Explain why we are dressed like that and what we are going to do next."

At Children's, whomever is holding the cervical spine or maintaining the airway gets right down next to the patient's ear and in a calm voice, tells them what is happening. "They also tell them what will be happening next, even if it is a painful procedure like arterial sticks or venous access, so there are absolutely no surprises," she says. "That person is always reiterating that we are taking care of them and they are doing a good job."

  • Make the child comfortable.

"Every little thing" you do for the child can make a difference, even something as simple as getting a blanket, says Baumann.

  • Involve parents as much and as soon as possible, for children of any age.

Family presence is key to calming a toddler in an intense situation, such as when a child is in manual cervical spine immobilization and staff are unable to calm the patient to maintain proper alignment. "Sometimes the teenagers need to hear from mom and dad, "Don't worry about the car, let's just get you well," says Baumann. If the parents have not yet arrived, you can say these words instead, she says: "Your parents love you. They want you to be OK. Don't worry about the car right now."