Recognition is the process of identifying when a patient's behaviour, communication, emotional response, or engagement with care may be influenced by previous traumatic experiences. Recognition does not require knowing a patient's trauma history or determining if/when trauma has occurred. Instead, it involves approaching every patient interaction with the understanding that trauma is common and may shape how individuals experience emergency care.
By recognising when trauma may be influencing an interaction, providers can adapt their communication and approach to promote safety, trust, and compassionate care without compromising clinical assessment or treatment.
Recognition begins with curiosity, asking "What factors may be influencing how this patient is experiencing this moment?"
Recognition is the foundation of trauma-informed practice. Before providers can reassure their patients or work to reduce the risk of re-traumatization, they must first recognise that trauma may be influencing the encounter.
Trauma can affect how patients communicate, respond to physical touch, interpret instructions, process information, or engage with healthcare providers. Behaviours that may initially appear resistant, withdrawn, aggressive, or non-compliant are not always intentional and may reflect adaptive responses developed through previous experiences.
Recognition encourages providers to pause before making assumptions, allowing them to interpret behaviours within a broader clinical and psychosocial context while continuing to deliver safe, effective emergency care.
Important: None of these signs confirm that a patient has experienced trauma. They simply indicate that a trauma-informed approach may be beneficial. The list below is not comprehensive.
Difficulty answering questions
Minimal or one-word responses
Contradictory information
Reluctance to disclose personal information
Delayed responses
Anxiety or panic
Mood swings
Irritability or anger
Emotional numbness
Tearfulness
Hypervigilance
Withdrawal
Agitation
Avoidance of eye contact
Hesitation during assessment
Startle reactions
Muscle tension
Guarding
Difficulty tolerating physical touch
Rapid breathing unrelated to medical findings
Collegiate EMS operates within a unique environment. Providers often respond to classmates, roommates, teammates, and friends during some of the most difficult moments of their lives. Presentations where trauma-informed recognition may be especially valuable include:
Mental health emergencies
Sexual violence or intimate partner violence
Substance-related emergencies
Suicide attempts or self-harm
Serious medical emergencies
Injuries resulting from interpersonal violence
First-time interactions with the healthcare system
Trauma-informed recognition begins before the first question is asked. As you approach every patient, consider:
Does the patient appear fearful or unusually guarded?
Has their behaviour changed during the interaction?
Are they reacting strongly to physical proximity or touch?
Do they appear overwhelmed by questions or instructions?
Could a different communication style improve this interaction?
Reminder: Recognition does not require providers to diagnose trauma, make assumptions about a patient's history, or explain every behaviour through a trauma-informed lens. Instead, it encourages providers to remain curious, avoid premature judgments, and consider trauma as one of many factors that may influence a patient's presentation.
*Video coming soon*