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September 29, 2021

Embracing a Trauma-Informed Approach to Patient Care—In With the New

Author Affiliations
  • 1Division of General and Trauma Surgery, Department of Surgery, WakeMed Health and Hospitals, Raleigh, North Carolina
  • 2Department of Surgery, University of North Carolina at Chapel Hill
  • 3Division of Community and Population Health, Department of Internal Medicine, WakeMed Health and Hospitals, Raleigh, North Carolina
JAMA Surg. 2021;156(12):1083-1084. doi:10.1001/jamasurg.2021.4284

As surgeons, we know trauma. We easily bring to mind commonly accepted examples: the 2-car pileup with multiple fatalities, the fall off a ladder, and the gunshot wound to the abdomen. We see people bloody, bruised, and broken every day and we come to believe that trauma surgeons care for patients only on those patients’ most dramatic and clearly life-threatening days. Unfortunately, for many patients, this does not tell the whole story.

Exposure to multiple traumatic events across the life span is regrettably common. Approximately 2 in 3 children experience trauma or chronic stress, and almost 90% of adults experience at least 1 traumatic exposure, as defined by the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5), in their lifetime.1 These negative experiences collectively elevate a patient’s risk for long-term health conditions and subsequent trauma recidivism.2-4 These data highlight 2 central questions. Do we who provide medical care truly understand how various types of trauma may affect a patient? And if not, can we genuinely deliver optimal care?

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