PTSD Protocol: Progress Over Time
Growing the PTSD Program PTSD screening went live in January 2018 with trauma patients scheduled for follow up visits to the trauma clinic utilizing the PTSD Checklist (PCL-5), which is a self-report questionnaire with 20 questions, to be completed by the patient during their visit to the trauma clinic. Completed questionnaires are then collected and scored by the BI Social Worker. If a patient scores a 31 or higher the BI Social Worker will reach out to the patient and discuss the screen and any concerns or needs for further help. Patients who score at risk for PTSD receive a follow-up call and are rescreened at 30, 60 and 90 days after the initial screen. In 2019, the Trauma ICU Pilot Expansion was implemented to reach more trauma patients who could potentially suffer from PTSD. Trauma ICU patients must be in the ICU for four or more days and fit into at least one of the following categories: • Injuries in two or more body systems (ortho, neuro, trauma) • Psychopathology (death involved in the traumatic event,
Acute Stress Disorder
Acute Stress Disorder (ASD) symptoms persist for a minimum of three days and last no more than one month.
Intrusion
Negative mood
Dissociative symptoms
Avoidance
Arousal symptoms
Post-Traumatic Stress Disorder
PTSD symptoms begin within a month of the trauma but sometimes can begin years afterward.
suicide intent, substance use) • CRRT, ventilator or dialysis use • Have the flu, C. diff, lice or COVID
Re-experiencing
The Trauma Services PTSD Program has been successful in providing resources and referrals for treatment to trauma patients who are at risk for PTSD. With continued review of the PTSD protocol in 2024, TSN became more involved with in-patient dissemination of PTSD information and resources for trauma patients.
Avoidance
Changes in arousal and reactivity
Changes in cognition and mood
TSN provides an informational resource letter to trauma patients who meet the following criteria:
Trauma Services has been able to meet trauma patients and their families using the TSN to address ASD symptoms. The American College of Surgeons supports efforts to screen and refer trauma patients with PTSD symptoms. In 2018, efforts to identify and address PTSD symptoms experienced by trauma patients began with follow up from the Brief Intervention Social Worker (BI Social Worker) and trauma patients were able to talk with someone and be linked to resources for treatment.
• Follow-up from TSN • Received a peer visit • Received a Pastoral Care consult
• Expressed interest in additional emotional support Those patients will also receive a three-month follow-up letter with the PTSD Checklist to complete and return to the BI Social Worker for scoring and follow up.
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A Reminder of Miracles
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