PFA in Practice!

A 6-year-old boy (“Mikey”) presents to the ED due to a wildfire. Mom and Mikey were separated at the hospital. Mom is receiving medical treatment related to burns. Mikey has some minor cuts on his arms. Mikey is crying and continues to ask about his mom.  You’ve been asked to respond to Mikey.   

What Should You Do? 

Consult your PFA Field Operations Guide (accessed through the National Child Traumatic Stress Network – see resources).  Assess for Mikey’s current needs in the following areas: Behavioral, Emotional, Physical, and Cognitive.

Mikey has received medical treatment for his cuts.  He is experiencing anxiety related to being separated from his mother and due to being in a new medical setting.  He is tearful and having difficulty remembering and describing what happened.

Contact and Engagement:  Ask about immediate needs.  What can you do to make Mikey more comfortable?  You find out the location of Mikey’s mom and assure him that she is being taken good care of at the hospital. You get Mikey a cup of water.

Information Gathering:  Find out what Mikey knows about the wildfire.  Mikey doesn’t know his phone number or address.  He is not a patient that is within your hospital system. Once calm, Mikey remembers that he has contact information on the tongue of his shoe. Mikey reports that his dad wasn’t home and that he’s been away from the house for a while.

Connection with Social Supports: You call the two phone numbers listed in Mikey’s shoe. Dad answers the phone.  He is away on a business trip.  He provides all contact information and will arrange for grandma to come to the hospital.  You call grandma and develop a plan for grandma to connect with Mikey.

Information on Coping: Explain the action plan to Mikey.  Use developmentally-appropriate language and check-in to make sure that he understands that his mother is being taken care of by doctors, his dad is on his way home, and grandma is coming to pick him up.  Explain that you will continue to check in on him until his grandma comes. You see that he has a superhero t-shirt on.  You initiate conversation about the superhero and tell Mikey that he has been very brave.  You coach him on how to take deep breaths.  You practice with him breathing in through your nose like you are smelling a flower and out through your mouth like you are blowing out a birthday candle. 

Mikey is now calm and you are able to attend to other patients presenting to the ED