Published onChildren's Doctor
Christopher E. Gaw, MD, MBE
Our Emergency Department at Children’s Hospital of Philadelphia is a constant hub of activity. Conversations of various volumes hum in patient rooms and touchdown spaces. Monitors and infusion pumps punctuate the air with their intermittent chimes. And stretchers and supply carts rumble through the hallways. One area of the ED, however, offers a paradoxical respite from all the visual and sensory stimuli. Save for the soft hum of fluorescent lights and medical equipment, the trauma bay often lies empty and silent.
Unlike the main Emergency Department, the trauma bay is defined by staccato-like moments. A sudden phone call or overhead EMS urgency signals its awakening. A burst of activity follows—the donning of PPE and preparation of supplies, the urgent coordination of care upon the child’s arrival, and the inevitable movement of staff and patient out of the bay. In a matter of minutes, the moment ends, and the trauma bay returns to its slumber.
For providers, a trauma bay activation represents a rapid focus on time-sensitive, life-saving medical decisions. But the moment embodies something different for both parent and child. For a parent, it marks a sudden, unexpected loss of control. For a child, it represents a situation imbued with fear and uncertainty. And for some families, it heralds the pivotal instant where their life trajectory is forever changed.
If you observed one of these moments in our trauma bay, you would see more than just a flurry of clinical activity. The calm voice of a child life specialist steadily coaches a patient on what to expect next. One of the nurses grabs a warm blanket while another holds the child’s hand. A social worker and clinician sit next to a parent, providing emotional support and medical updates. Each small gesture aims to replace some of the fear with comfort, some of the uncertainty with support.
As emergency medicine providers, we cannot undo the injury, nor can we completely erase the pain and anxiety of the situation. But we each strive to redefine the moment in the trauma bay, to guide patients and families with grace and dignity to the next step in their care and the life that follows.
References and further readings
American Academy of Pediatrics Committee on Pediatric Emergency Medicine, American College of Emergency Physicians Pediatric Emergency Medicine Committee. Patient- and family-centered care and the role of the emergency physician providing care to a child in the emergency department. Pediatrics. 2006;118(5):2242-2244.
Center for Pediatric Traumatic Stress. Pediatric Medical Traumatic Stress: Healthcare Toolbox. Updated 2021. Accessed November 5, 2021. https://www.healthcaretoolbox.org.