Hospitals can traumatize children undergoing medical procedures due to fear of the unknown, pain, and loss of control over their body. To minimize trauma, hospitals should treat children with respect, explain procedures simply, allow time to familiarize themselves with the hospital environment before visits, and involve Child Life specialists who prepare children through medical play and distraction techniques. The goal is to help children feel safe and in control to reduce stress of the healthcare experience.

1. Hospital Trauma What it is and how to minimize it

2. Why is the hospital traumatizing? While hospitals have come a long way since the 1940s and '50s, medical procedures performed on children still are often experienced as frightening, painful, and overwhelming. Procedures are often tricky and frightening, not to mention potentially harmful

3. What can hospitals due to prevent this? increased respect and dignity given to children because all aspects of the child (body, mind, and spirit) would be considered Provide a commitment to total care of each child AND their family Doctor engage with child in a way that is familiar (i.e. Play) so he is not a "stranger; explains event sequence in simple language

4. What can hospitals due to prevent this? Knowledge about what autonomic nervous system dynamics cause trauma (symptoms come from immobility, helplessness, and energy bound in the thwarted flight-or-fight response) teaching everyone involved to be alert to child's feelings and strive to lessen anxiety; body language and facial expressions often tell of fear better than words Visits to hospital done prior to day of surgery to allow for time to play "hospital" at home

5. What can Child Life do to help? Child Life Specialists plan individualized and group programs that prepare children by familiarizing them with things they may experience in a way that helps lessen fear & anxiety simulated equipment books with age appropriate photos of what they will experience step-by-step "Jeffrey", life-sized doll dressed in child-friendly hospital pajamas and blue surgical cap with special box containing EKG stickers, pulsometer, IV, blood pressure cuff, and a syringe so children can look at, feel and play with what they will experience

6. What can Child Life do to help? Child Life programs can also provide: child with his or her own doll and medical play kit (mask, syringe, gloves, cotton, alcohol swab, baid-aid, tongue depressor, medicine cup) arts, crafts, imaginiative play, special video conferencing through "Starbright World" (protected Health Care Organization connecting children with similar medical conditions internationally online), pet visits, one-to-one bedside games

7. What should everyone keep in mind? What children overhear can be just as traumatizing as what they experience Teaching children how the procedure will affect them, as well as determining with the child what would help them feel safe and comfortable, introducing them to sensations, role- playing making boundaries, and helping them find ways to access inner resources in order to maintain a sense of control are important parts of reducing trauma related to medical procedures

8. Reference: Levine, P. A. & Kline, M. (2007). Transforming medical care for the future: A plan to minimize pediatric trauma. In Trauma through a child's eyes (pp. 441-457). Berkley, CA: North Atlantic Books.