449 - Relationship between treatment of Non-Accidental Trauma cases on Post-Traumatic Stress Disorder in Pediatric Emergency Medicine Providers

Publication Number: 4440.449

Kenneth Reeve, University of Buffalo, Clarence, NY, United States; Brian Wrotniak, John R. Oishei Children's Hospital, Buffalo, NY, United States; Heather Territo, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States

Background: Non-accidental trauma (NAT) cases are a unique subset which places a great amount of stress on pediatric emergency medical providers. Although previous research has examined the effects of NAT on patients and families, there is limited research on its impact on health care workers. Prior studies have shown high rates of post-traumatic stress symptoms among healthcare workers following other acute stressors, such as the COVID-19 pandemic.

Objective: The purpose of this study was to determine the association of Post Traumatic Stress Disorder (PTSD) in ED providers caring for children with NAT.

Design/Methods: A cross sectional survey of pediatric emergency medicine providers was conducted to assess PTSD symptoms related to caring for children with NAT. The survey used the PTSD Checklist for DSM-5 (PCL 5) and was distributed through the Brown University Pediatric Emergency Medicine listserv. PTSD was examined as total survey score as well as a a dichotomized variable of probably vs. subclinical PTSD based on recognized cutoffs. NAT was characterized as the total number of reported NAT cases seen. Moderators, including reported level of violence to the provider and to the staff, were examined.

Results: A total of 177 surveys were included for the analysis. Based on summed PCL-5 scores, five respondents met criteria for probable PTSD. Providers in the probable PTSD group had substantially greater NAT case exposure than those with subclinical symptoms (median 366 vs. 126 lifetime cases; p =0.05, Mann–Whitney U test).
Spearman correlation analysis demonstrated that total PCL-5 score was moderately correlated with the provider’s perceived level of violence in the NAT case (R= 0.60). No significant correlations were found between PCL-5 scores and frequency of NAT cases, having children, or the belief that having children influenced emotional response.

Conclusion(s): Providers with probable PTSD reported significantly greater exposure to NAT cases than providers within the subclinical range for PTSD. Perceived case violence was moderately associated with higher total PTSD symptom scores. These findings suggest that increasing NAT exposure—particularly when cases involve verbal or physical violence—may elevate PTSD risk among pediatric emergency providers.