Approximately one-quarter of emergency department patients who are injured or experience medical emergencies will develop clinically significant posttraumatic stress disorder (PTSD) symptoms, which can evolve into PTSD. Emergency clinicians and rapid response teams (eg, trauma, cardiac, stroke) can play a critical role in recognizing symptoms of posttraumatic stress and providing early distress management techniques, screening, and referral to services that may mitigate the development of PTSD. This review summarizes the existing literature on psychological distress related to events that trigger the need for emergency care and synthesizes cutting-edge approaches that may impact patient outcomes.
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Following are the most informative references cited in this paper, as determined by the authors.
1. * Edmondson D, Richardson S, Fausett JK, et al. Prevalence of PTSD in survivors of stroke and transient ischemic attack: a meta-analytic review. PLoS One. 2013;8(6):e66435. (Meta-analysis; 9 studies) DOI: 10.1371/journal.pone.0066435
7. Office of the Assistant Secretary for Planning and Evaluation US Department of Health and Human Services. Trends in the utilization of emergency department services, 2009-2018. 2021. Accessed December 10, 2022. (Report to US Congress)
8. * Kovalsky D, Roberts MB, Freeze B, et al. PTSD symptoms after respiratory and cardiovascular emergencies predict risk of hospital readmission: a prospective cohort study. Acad Emerg Med. (Prospective; 99 patients) DOI: 10.1111/acem.14438
9. * Bulger EM, Johnson P, Parker L, et al. Nationwide survey of trauma center screening and intervention practices for posttraumatic stress disorder, firearm violence, mental health, and substance use disorders. J Am Coll Surg. 2022;234(3):274-287. (Nationwide survey; 322 trauma centers) DOI: 10.1097/XCS.0000000000000064
10. Weathers FW, Litz BT, Davis MT, et al. The PTSD Checklist for DSM-5 (PCL-5). 2013. Accessed December 10, 2022. (PCL-5 scale checklist)
16. * Lowe SR, Ratanatharathorn A, Lai BS, et al. Posttraumatic stress disorder symptom trajectories within the first year following emergency department admissions: pooled results from the International Consortium to predict PTSD. Psychol Med. 2021;51(7):1129-1139. (Pooled analysis; 3083 participants) DOI: 10.1017/S0033291719004008
82. Brymer ML, C; Jacobs, A; National Child Traumatic Stress Network and National Center for PTSD. Psychological First Aid (PFA) Field Operations Guide, 2nd Edition. 2006; Accessed December 10, 2022. (Field operations guide)
84. American Psychological Association. Professional practice guidelines for evidence-based psychological practice in health care. 2021. Accessed December 10, 2022. (Evidence-based guidelines)
87. US Department of Health and Human Services. SAMHSA’s concept of trauma and guidance for a trauma-informed approach. 2014. Accessed December 10, 2022. (Guidelines)
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Keywords: PTSD, posttraumatic stress, anxiety, intrusion, DSM-5, psychological first aid, trauma-informed care
Maria Lynn Pacella-LaBarbara, PhD; Enzo G. Plaitano, BA, NRP; Bernard P. Chang, MD, PhD
Nicholas Schwartz, MD; Joseph D. Toscano, MD
January 1, 2023
January 1, 2026   CME Information
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 2 Trauma CME credits and 4 Behavioral Health CME credits.
Price: $59
+4 Credits!
Maria Lynn Pacella-LaBarbara, PhD; Enzo G. Plaitano, BA, NRP; Bernard P. Chang, MD, PhD
Nicholas Schwartz, MD; Joseph D. Toscano, MD
January 1, 2023
January 1, 2026
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 2 Trauma CME credits and 4 Behavioral Health CME credits.