Pediatric Trauma Mental Health Screening Guideline

Original Date: 08/2023 | Supersedes: 08/2023 | Last Review Date: 10/2023
Purpose: The purpose of this guideline is to identify pediatric trauma patients at high risk for post-trauma mental health adjustment disorder post-injury and facilitate brief interventions, and appropriate referrals.

Childhood traumatic stress happens when unexpected, violent, life-threatening, or devastating events overwhelm the ability to cope. ACS reports that 20-30% of pediatric trauma patients report mental health symptoms and/or decreased quality of life (2022, ACS BPG)

Procedure:

Mental health assessment screening to be included in tertiary assessment which is usually completed in the first or second day of admission. However, screening will be delayed until GCS>/= 14. Children with hospital stays greater than 1 week will be reassessed

Traumatic Events that warrant screening:

  • Neglect and psychological, physical, or sexual abuse.
  • Victim of community and school violence.
  • Victim of gun related violence (intentional self-inflicted GSW or suicidal attempt will prompt child psychiatry consult)
  • Serious traumatic event causing life-threatening and devastating injuries (Traumatic Brain Injury, SCI, loss of limb, mutilating/deforming injuries)
  • Prolonged hospital stay- (longer than 1 week)
  • Death of family member in crash.
  • Care provider discretion

Patients identified as high risk for post injury mental health disorder will undergo a brief screening by the pediatric trauma NP using the following screening tool:

ASC6/ASC3 screening
https://www.healthcaretoolbox.org/sites/default/files/2021-03/ASC-Kids%20English%20and%20Spanish%20with%20scoring%20info%20-%20all%20versions%20SAMPLE.pdf

Patients who screen positive are referred to one of the following resources to ensure appropriate interventions:

  • Child psychology team
  • Child psychiatric team

Patients who do not screen positive may be referred to the trauma resilience clinic post discharge.

References:
American College of Surgeons. (2022, December). Best Practices Guidelines: Screening and Intervention for mental health disorders and substance use and misuse. https://www.facs.org/media/nrcj31ku/mental-health-guidelines.pdf

The Acute Stress Checklist (ASC-kids) (2016), https://www.healthcaretoolbox.org/acute-stress-checklist