Trauma-Informed Care fundamentals

Trauma-informed care (TIC) is an evidence-based approach to patient care that emphasises safety, trust, empowerment, and collaboration in healthcare encounters. It is based on the knowledge that patient responses are shaped not only by current illness or injury, but also by prior adverse experiences, which may include (but are not limited to) medical mistreatment, discrimination, interpersonal violence, or systemic inequities. A trauma-informed approach acknowledges these influences and aims to minimise the risk of retraumatization while fostering a sense of agency and partnership in care. 

TIC is not to be mistaken for therapy or trauma treatment. Instead, it is a framework that guides the delivery of care. A trauma-informed approach prompts providers to consider "What may have happened to this person, and how might that influence today's interaction?" rather than "What is wrong with this patient?"

Collegiate EMS occupies a unique space within healthcare. In student-led organisations, responders care for their peers, classmates, and friends in environments that are often public, emotionally charged, and time-sensitive. Patients may arrive with a plethora of previous experiences that influence how they respond to care. A routine assessment, physical examination, or question may unintentionally trigger fear or distress.

Up to 84% of college students have experienced at least one “potentially traumatising” event. As of 2024, 47% of students seeking college counselling services report experiencing trauma, compared to 37% in 2012.

TIC helps responders recognise these possibilities and adapt their approach without compromising clinical care. Small actions, such as introducing yourself, explaining procedures before performing them, asking permission whenever possible, and providing choice, can strengthen trust while also improving the patient experience. 

Importantly, TIC also supports responders. It is estimated that up to 50% of EMS providers experience feelings of burnout. This figure is likely even higher in collegiate EMS, where responders are routinely exposed to emotionally challenging calls while balancing academic responsibilities and caring for members of their campus community. A trauma-informed culture recognises that responder well-being is essential to providing high-quality patient care.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has established a widely recognised framework for trauma-informed care that guides practice across healthcare, education, and community organisations. At its core are six guiding principles that promote compassionate, patient-centred interactions across healthcare settings.

1.) Safety

Promote both physical and psychological safety for patients, providers, and those involved in care.

2.) Trustworthiness and Transparency

Communicate clearly and honestly to foster trust and reduce uncertainty.

3.) Peer Support

Recognise the value of supportive relationships in promoting resilience and recovery.

4.) Collaboration and Mutuality

Approach care as a partnership whenever possible, acknowledging that patients are active participants in their own care.

5.) Empowerment, Voice, and Choice

Respect patient autonomy by encouraging participation in decision-making.

6.) Cultural, Historical, and Gender Considerations

Deliver care that acknowledges and respects each person's unique identity, lived experiences, and cultural background.

While the SAMHSA principles provide a strong foundation for TIC, applying them in fast-paced emergency settings can be challenging. To support collegiate EMS providers, we've translated these concepts into three practical tenets that can guide patient interactions in the field. 

Select any of the three tenets to learn more.

*Video coming soon*