Pediatric Trauma Mental Health and Substance Abuse Screening Process
Alcohol Misuse Screening and Intervention
Based upon ACS requirements, the pediatric trauma program requires all admitted patients, ages 12 and up, be screened for use/misuse of alcohol.
Admitted patients, for the purposes of this requirement, are considered those admitted for >24 hours. Patients held in the Peds ED for observation and outpatients may benefit but are exempt.
Screening is performed using the CRAFFT tool (which stands for the key words of Car, Relax, Alone, Forget, Friends, Trouble and is validated for 12-17-year olds) or blood alcohol test (Pediatric Trauma Alert and Alert Red orders include an ETOH level and UDS for patients aged 12 – 15). And can be performed any time prior to patient discharge.
The on-duty ED SW, when available, or the KCH LCSW conducts CRAFFT screening on age appropriate admissions and documents results within SW note and/or CRAFFT EPIC flowsheet.
The ED SW or KCH LCSW conduct a brief intervention with those patients who screen positive for alcohol misuse. Child psychology or psychiatry may be consulted as indicated or needed.
Mental Health Screening
The pediatric trauma program requires mental health screening on all admitted pediatric trauma patients age 8-15 years, based upon ACS requirements. Mental health screening identifies patients’ risk for psychologic sequelae related to their traumatic event, mechanism of injury.
Admitted patients, for the purposes of this requirement, are considered those admitted for >24 hours. Patients held in the Peds ED for observation and outpatients may benefit but are exempt.
Screening is performed using the ACS-6 (Acute Stress Checklist) tool, developed by the Center for Pediatric Traumatic Stress and validated for children aged 8-17 years.
The on-duty ED SW, when available, or the KCH LCSW conducts ACS screening on age appropriate admissions and documents results within SW note and/or EPIC flowsheet.
The SW or PDS service provide appropriate resources and/or child psychology/psychiatry consult for those children who screen high risk for acute stress disorder.
NOTE: The parent or legal guardian provides consent for any intervention; and ONLY the parent or legal guardian can decline intervention. Declinations should be clearly documented as such.
Communication of Process to Team
The guideline is included with the other trauma clinical practice guidelines, made available to all residents and trauma staff.
An email is sent to residents at the start of their rotation explaining the process (attached).