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Life After Trauma

A Survey of Level 1 Trauma Centers Regarding Posttraumatic Stress Disorder and Acute Stress Disorder

Guess, Katherine E. MD, MPH; Fifolt, Matthew PhD; Adams, Raeanna C. MD; Ford, Eric W. PhD; McCormick, Lisa C. DrPH, MPH

doi: 10.1097/JTN.0000000000000451
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Patients admitted to Level 1 trauma centers in the United States are rarely assessed for or educated about the potentially devastating effects of acute stress disorder (ASD) or posttraumatic stress disorder (PTSD). This descriptive research was conducted to describe current levels of assessment and education of ASD and PTSD in Level 1 trauma centers in the United States. The aims of this article are to (1) determine the extent to which Level 1 trauma centers in the United States assess and educate patients and providers about ASD and PTSD and (2) identify clinical staff who administer assessments and provide educational resources. A web-based survey was distributed to the trauma program managers and trauma medical directors of 209 adult and 70 pediatric Level 1 trauma centers in the United States. For PTSD, 26 (25.00%) adult and 17 (36.17%) pediatric centers had an assessment protocol for use with trauma patients. For ASD, 13 (12.50%) adult and 13 (27.66%) pediatric centers utilized an assessment protocol for use with trauma patients. For PTSD, 12 (12.37%) adult and 8 (20.00%) pediatric centers offered educational protocols for use with trauma patients. Seven (7.22%) adult and 7 (17.50%) pediatric centers maintain educational protocols for ASD in trauma patients. Fewer centers had assessment or educational protocols targeting formal and informal caregivers. This study was limited to Level 1 trauma centers in the United States. Results indicate that trauma patients are rarely assessed for or educated about the potential effects of PTSD or ASD. Formal and informal caregivers are also assessed and educated at low rates. Assessment, education, and incidence of PTSD and ASD should be included as universally measured health outcomes across trauma centers.

University of Arkansas for Medical Sciences, Little Rock (Dr Guess); Departments of Health Behavior (Dr Guess), Health Care Organization and Policy (Drs Fifolt and Ford), and Environmental Health Science (Dr McCormick), School of Public Health, University of Alabama at Birmingham; and Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Adams).

Correspondence: Matthew Fifolt, PhD, Department of Health Care Organization, School of Public Health, University of Alabama at Birmingham, RPHB 330M, 1665 University Blvd, Birmingham, AL 35294 (mfifolt@uab.edu).

The authors declare no conflicts of interest.

Copyright © 2019 by the Society of Trauma Nurses.