Posttraumatic stress disorder and injury

Growing empirical evidence indicates that injury (both intentional and unintentional) is a primary risk factor for posttraumatic stress in children. Most injured children do well, drawing on their own coping skills and the support of their family. However, a small percentage of patients develop distressing posttraumatic symptoms, including posttraumatic stress disorder (PTSD). Emergency physicians see children and parents at a key time post-injury, and have a unique opportunity to promote psychological resilience and recovery from injury, and to identify individuals in need of further assessment and intervention. This article will review some of the normal psychological responses to trauma, the association between injury and the development of PTSD, risk factors for PTSD, and interventions that can be performed in the emergency department and afterward to prevent serious psychological sequelae.