Oct 21, 2015 1:00 AM

Author: Zach Robinson

Child talking to doctor

Why is my dad not waking up? What are these machines for? Can I touch my dad? Children can have many questions when someone they love suffers a traumatic injury. It is unlikely they can process that a parent or sibling is fighting to survive or understand every detail of their medical care.  

How best can providers handle such a difficult situation? According to Kristen Quinn, CMHC, CCLS, a social worker with the Burn Trauma Intensive Care Unit at University of Utah Hospital, the best way is to start off simple. “Ask them to tell you what they know about what happened,” she says. A lot of the time kids will have incomplete or inaccurate information about what has happened or is happening. Once providers have an idea of a child’s grasp on the situation, they can determine how to proceed.

“Tell me what you want to know” is a simple request that helps providers move forward, according to Quinn. It reduces the risk of overwhelming kids with information they didn’t want or were not ready to hear. Let them know they can always ask more questions if they don’t want all of the facts right then.

Preparation is key prior to a child visiting a parent in an ICU or trauma bay, starting with what they will see, hear, feel, and smell. Have the caregiver (this keeps patient photos off staff phones and reduces HIPAA risks) take a picture of the broad scope of the room–including the patient bed–the basic equipment (always include the urine bag, monitors, and ventilator) and maybe a unit staff member.  The child then can be given information about what to expect and see in the room before experiencing it.

It can also help to have children draw a picture of what they believe the room will look like, and write down questions they may have once they see the room. It is also advisable to have kids make signs for their loved ones. “Tell them the signs will help remind staff that they are caring for someone important,” says Quinn.

Above all else, providers need to be honest with everyone involved–including children. If survivability is questionable, providers should use language like “We are working really hard to help, but everyone is very worried; sometimes a body is hurt too badly to survive, but we are doing everything we can. We don’t know why this happened-but it was not because of anything you did or thought.” Questions about machines should also be answered simply but honestly. 

Providers know that families are important in the care process. Following these few simple tips can lead to a strong relationship between providers and patients and their young children. 

Zach Robinson

Zach Robinson MPA, EMT-P, is the Trauma Outreach/Injury Prevention Coordinator at University of Utah Hospital. Follow him on Twitter @UofUtrauma.

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