Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 13;23(3):334-344.
doi: 10.5811/westjem.2022.1.53674.

Trauma-informed Care Interventions in Emergency Medicine: A Systematic Review

Taylor Brown  1 , Henry Ashworth  2 , Michelle Bass  3 , Eve Rittenberg  4 , Nomi Levy-Carrick  5 , Samara Grossman  5 , Annie Lewis-O'Connor  4 , Hanni Stoklosa  6
Affiliations

Trauma-informed Care Interventions in Emergency Medicine: A Systematic Review

Taylor Brown et al. West J Emerg Med. .

Abstract

Introduction: Trauma exposure is a highly prevalent experience for patients and clinicians in emergency medicine (EM). Trauma-informed care (TIC) is an effective framework to mitigate the negative health impacts of trauma. This systematic review synthesizes the range of TIC interventions in EM, with a focus on patient and clinician outcomes, and identifies gaps in the current research on implementing TIC.

Methods: The study was registered with PROSPERO (CRD42020205182). We systematically searched peer-reviewed journals and abstracts in the PubMed, EMBASE (Elsevier), PsycINFO (EBSCO), Social Services Abstract (ProQuest), and CINAHL (EBSCO) databases from 1990 onward on August 12, 2020. We analyzed studies describing explicit TIC interventions in the ED setting using inductive qualitative content analysis to identify recurrent themes and identify unique trauma-informed interventions in each study. Studies not explicitly citing TIC were excluded. Studies were assessed for bias using the Newcastle-Ottawa criteria and Critical Appraisal Skills Programme (CASP) Checklist.

Results: We identified a total of 1,372 studies and abstracts, with 10 meeting inclusion criteria for final analysis. Themes within TIC interventions that emerged included educational interventions, collaborations with allied health professionals and community organizations, and patient and clinician safety interventions. Educational interventions included lectures, online modules, and standardized patient exercises. Collaborations with community organizations focused on addressing social determinants of health. All interventions suggested a positive impact from TIC on either clinicians or patients, but outcomes data remain limited.

Conclusion: Trauma-informed care is a nascent field in EM with limited operationalization of TIC approaches. Future studies with patient and clinician outcomes analyzing universal TIC precautions and systems-level interventions are needed.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. This work was funded by the Robert Wood Johnson Foundation Clinical Scholars Program. There are no conflicts of interest to declare.

Figures

Figure 1
Figure 1
PRISMA flow diagram. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; TIC, trauma-informed care.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Centers for Disease Control and Prevention. Violence Prevention at CDC. 2020. [Accessed July 15, 2020]. Available at: https://www.cdc.gov/violenceprevention/publichealthissue/index.html.
    1. Gani F, Sakran JV, Canner JK. Emergency department visits for firearm-related injuries in the United States, 2006–14. Health Affairs. 2017;36(10):1729–38. - PubMed
    1. Davidov DM, Larrabee H, Davis SM. United States emergency department visits coded for intimate partner violence. J Emerg Med. 2015;48(1):94–100. - PMC - PubMed
    1. Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3(3):e203976. - PMC - PubMed
    1. Marketing General Incorporated. ACEP Emergency Department Violence Poll Research Results. 2018. [Accessed July 15, 2020]. Available at: https://www.emergencyphysicians.org/globalassets/files/pdfs/2018acep-eme....

Publication types