Topical Review: Integrating pediatric psychology into PICUs: improving screening and interventions for medical trauma.

Abstract

Objective: Provide an overview of medical traumatic stress in pediatric critical care and highlight pediatric psychology as a central mechanism for translating evidence into trauma-informed screening, prevention, and intervention practices within pediatric intensive care units (PICUs).

Methods: Current literature is synthesized to characterize medical traumatic stress, identify trauma-informed practice guidelines, and propose recommendations for improved integration of pediatric psychology into critical care settings.

Results: High rates of medical traumatic stress and posttraumatic stress disorder (PTSD) are reported among critically ill children, caregivers, and PICU staff, with identifiable risk factors. Current and emerging standards of care reviewed include traumatic stress and delirium screening, early mobility initiatives, PICU follow-up programs, trauma-focused interventions, and staff debriefing efforts.

Conclusions: Medical traumatic stress is a common outcome of PICU hospitalization. Earlier integration of pediatric psychology services during and following PICU admission offers promise for improving outcomes, advancing trauma-informed care, and informing future research across the PICU continuum.