You've heard of ACEs and ABCs, but what about DEF? Here we learn about trauma-informed care.

This episode was written by pediatric resident Mallika Iyer-Horiuchi with content support from pediatricians Tammy Yau, Lidia Park, and Jihey Park (general pediatrics). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

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Key Points

• Trauma informed care improves patient interactions and outcomes. Remember the mnemonic DEF which stands for treat Distress, support Emotions, include the Family.”
• Pain, fear, and uncertainty can amplify trauma responses—treating distress quickly improves both cooperation and recovery.
• Clear explanations, caregiver presence, and simple coping strategies can significantly reduce pediatric medical traumatic stress.
• Caregivers’ stress affects the child’s recovery—supporting the family supports the patient.



Sources:

1. James Duffee, Moira Szilagyi, Heather Forkey, Erin T. Kelly; COUNCIL ON COMMUNITY PEDIATRICS, COUNCIL ON FOSTER CARE, ADOPTION, AND KINSHIP CARE, COUNCIL ON CHILD ABUSE AND NEGLECT, COMMITTEE ON PSYCHOSOCIAL ASPECTS OF CHILD AND FAMILY HEALTH, Trauma-Informed Care in Child Health Systems. Pediatrics August 2021; 148 (2): e2021052579. 10.1542/peds.2021-052579
2. https://www.healthcaretoolbox.org/d-e-f-framework-trauma-informed-care
3. https://www.healthcaretoolbox.org/sites/default/files/images/pdf/DEFpocketcards.pdf
4. https://www.nctsn.org/