Pediatric P.A.U.S.E protocol to prevent PTSD
The Pediatric P.A.U.S.E [Beaulieu-Jones, 2022]
- P = Pain and Privacy;
- Address pain and treat it early!
- Remove unnecessary personnel and respect the individual’s privacy.
- A = Anxiety and Access;
- Address the patients fears in an age-appropriate manner.
- Determine whether IV access is necessary (not just reflexive).
- U = Urinary Cath / GU Exam / Rectal Exam;
- Determine whether foley or urinary cath will be necessary (unlikely).
- GU and Rectal exams increase anxiety and stress. Do you need to do it?
- S = Support for the Child from Family or Child Life Specialists (or PICU team);
- A team member should be positioned near the child’s head to communicate with the patient and give support.
- Family members can be used to help assuage anxiety.
- E = Explain to the Patient;
- Using age-appropriate communication let the patient know what is going on and what to expect.
- They may be tiny people, but they still have autonomy and like to have that respected.
Applying the Pediatric P.A.U.S.E [Beaulieu-Jones, 2022]
- The Pediatric P.A.U.S.E has been shown to be able to be performed expeditiously and without interfering with timely trauma evaluations.
- After the Primary Survey, if the patient is not deemed to be unstable and requiring emergent interventions, the Pediatric P.A.U.S.E. was able to be quickly reviewed (< 5minutes) prior to proceeding to Secondary survey.
My Humble Opinions… (sorry… every once in a while I get to speak my mind)
- Don’t be Cruel! Treat pain expeditiously!
- Not everyone needs Ketamine… but everyone needs to be treated like a person (even little people).
- Talk to your patient! Don’t just bark orders. Or… if you aren’t good at talking to children (you know who you are…), then designate someone who can.
- Slow down! Be thorough, not frantic. Very few procedures need to be done immediately in children… even chest tubes! Children tolerate pneumothoraces well.
- Not every hole needs a finger in it! Come on… we have long past the dark days of requiring rectal exams on everyone!
- If you don’t have Child Life… tell your boss and your boss’s boss that your pediatric patients and your team need them!
Moral of the Morsel
- First Do No Harm – Neither Physical Nor Emotional Harm!
- Simple actions can help decreased secondary injuries. Being kind and considerate (in the truest sense of those words) can help mitigate ongoing emotional trauma.
- PTSD does occur in all ages. Kids are not immune to it.
