Mental and physical responses of children to pain, injury, painful or difficult medical procedures or chronic illness is termed as Pediatric medical traumatic stress. These responses can also be towards invasive or frightening treatment experiences. Such traumatic events occurring one time or may be multiple times may be medical trauma.
Responses of children in result of medical trauma are rather subjective than objective in nature. Their responses vary in degree. Children’s functioning may also be disturbed in case of medical trauma. However, in most cases children and families show and do well. Almost every child who is severely ill (life-threatening illness, injury, or painful procedures) suffers from stress at some point. This stress can be persistent in some cases causing the following symptoms:
There are three main types of traumatic stress reactions:
Re-experiencing.
This type of stress makes the child to rethink the event over and over again. Here the children overthink the traumatic event and can’t have control over it. Although it is natural but too much of it can be distressing causing the child to be fearful. A child might have nightmares or “flashbacks” making him relive the whole event over and over again. It may make the child upset. Re-experiencing an event can also be through reinforcers like seeing something similar or a sound, a smell which provoke the stressful response as of reminding the child about the event.
Hyper-arousal.
Commonly termed as fight or flight response is natural to danger, pain or any traumatic event. In common cases after the painful stimulus is removed the body returned to its normal functioning however in some cases like an injury or accident this fight or flight response may not be turned off. It will cause the child to be aroused even after he or she is safe. Moreover, sometimes child after facing one traumatic event may feel that it can occur to him anytime. It causing feelings of distress and such feelings of fear may also make him over sensitive in future. He might jump at any loud noise or may experience feelings that go along with hyper-arousal (e.g., heart racing) .
Avoidance
Such symptoms can occur when child avoid thinking about the traumatic event or anything connected to it. Children may avoid certain people, places or activities that reminds them of the event. It may cause them be more fearful. Although it is healthy as it is good to be cautious however too much of it can disturb the child normal functioning. It may interfere with child day to day activities in a way that the child is overprotective about wearing seat belt, or avoid running or staying away from animals etc. All these symptoms of can stop a child from getting back to enjoying things that she usually likes to do.
Medical Trauma Resources
Online Resources:
- Trauma resource center websites: https://ncsacw.samhsa.gov/resources/trauma/trauma-resource-center-websites.aspx
- International Society for Traumatic Stress: https://istss.org/public-resources/friday-fast-facts/fast-facts-medical-trauma
- Medical Trauma The National Child Traumatic Stress Network: https://www.nctsn.org/what-is-child-trauma/trauma-types/medical-trauma
Articles:
- An overview of the American trauma system – NCBI – NIH: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911730/
- The impact of trauma systems on patient outcomes – NCBI – NIH: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286246/
- When Treatment Becomes Trauma: https://www.counseling.org/docs/default-source/vistas/when-treatment-becomes-trauma-defining-preventing-.pdf
Video resources:
- Friday Fast Facts -Medical Trauma: https://youtu.be/qrkJaygO0sY
- Pediatric Medical Trauma-Module 1: https://www.youtube.com/watch?v=4eRmPXIe5VE
- Wired for Danger: The Effects of Childhood trauma on the brain: https://youtu.be/OA4CqlL_PzE