{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T15:07:32Z","timestamp":1789571252598,"version":"build-2803163510"},"reference-count":23,"publisher":"American Medical Association (AMA)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"abstract":"\n Importance<\/jats:title>\n Trauma-informed care (TIC) is an approach that promotes patient safety, dignity, and agency within the clinical environment and has recently been incorporated into Advanced Trauma Life Support recommendations.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To characterize how TIC principles are applied during the initial evaluation of injured patients in the trauma bay and to assess whether TIC delivery differs between English-speaking patients and Spanish-speaking patients.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cross-sectional study analyzed audiovisual recordings from trauma assessments at 6 level I trauma centers enrolled from March 2024 to April 2025. Patients were included if they were alert, hemodynamically stable (systolic blood pressure &amp;gt;90; heart rate &amp;lt;120), and had a Glasgow Coma Scale score greater than 13. Data were analyzed from August to November 2025.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n A standard checklist was used to assess basic communication (eg, introductions), empathetic communication (eg, reassurances), and comprehensiveness of the examination. Differences in these elements were compared between English- and Spanish-speaking patients using \u03c7\n 2<\/jats:sup>\n ,\n t<\/jats:italic>\n tests, and Wilcoxon rank sum analyses.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 291 patient encounters (median [IQR] age, 41 (28-63) years; 162 male [55.7%]) were reviewed. The median (IQR) Injury Severity Score was 9 (1-14), and 216 encounters (74.6%) were for blunt injuries. There were 236 English-speaking patients (81.1%), 52 Spanish-speaking patients (17.9%), and 17 patients (32.7%) had an interpreter present for any part of the evaluation. A physician introduced themselves in 74 encounters (28.8%), less often for Spanish-speaking patients than English-speaking patients (3 of 49 encounters [6.1%] vs 71 of 208 encounters [34.1%];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Nurse introductions occurred in 26 encounters (10.0%). Spanish-speaking patients, compared with English-speaking patients, received fewer verbal reassurances (median [IQR], 1 [0-1] vs 2 [1-4] assurances;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and were less likely to be given at least 1 physical reassurance (7 of 51 encounters [13.7%] vs 118 of 229 encounters [51.5%];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Approximately half of patient interventions included any communication (mean [SD], 55.4% [29.5 percentage points]), with lower rates for Spanish-speaking patients than English-speaking patients (mean [SD], 46.5% [28.8 percentage points] vs 57.3% [29.4 percentage points];\n P<\/jats:italic>\n \u2009=\u2009.02). Few patients (97 [34.2%]) had complete physical examinations, and this was less frequent for Spanish-speaking patients than English-speaking patients (7 [13.7%] vs 90 [38.6%];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This cross-sectional study found that TIC practices, including fundamental communication, empathetic engagement, and patient-centered behaviors, were inconsistently delivered during acute trauma resuscitation. Spanish-speaking patients experienced lower rates of trauma-informed communication and were less likely to receive a complete examination. Improving the quality and equity of trauma care will require deliberate integration of trauma-informed principles into trauma education, performance improvement, and clinical practice.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamasurg.2026.4161","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T15:00:20Z","timestamp":1789570820000},"source":"Crossref","is-referenced-by-count":0,"title":["Evaluating Delivery of Trauma-Informed Care in the Trauma Bay"],"prefix":"10.1001","author":[{"given":"Erin E.","family":"Isenberg","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Texas at Southwestern, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reynaldo","family":"Olivo","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Texas at Southwestern, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahaa","family":"Succar","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Texas at Southwestern, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Perkins","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison E.","family":"Berndtson","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Frazee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Vanderbilt University, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel D.","family":"Appelbaum","sequence":"additional","affiliation":[{"name":"Department of Surgery, Vanderbilt University, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Maiga","sequence":"additional","affiliation":[{"name":"Department of Surgery, Vanderbilt University, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Loss","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oregon Health and Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Echo","family":"Meyers","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oregon Health and Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mackenzie","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oregon Health and Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaclyn A.","family":"VanDerWal","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel N.","family":"Holena","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical University of South Carolina, Charleston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Lombana","sequence":"additional","affiliation":[{"name":"Department of Surgery, The University of Kansas Medical Center, Kansas City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stepheny","family":"Berry","sequence":"additional","affiliation":[{"name":"Department of Surgery, The University of Kansas Medical Center, Kansas City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Dultz","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Texas at Southwestern, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan P.","family":"Dumas","sequence":"additional","affiliation":[{"name":"Department of Surgery, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"issue":"3","key":"soi260062r2","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1353\/hpu.2013.0120","article-title":"The prevalence of trauma and childhood adversity in an urban, hospital-based violence intervention program.","volume":"24","author":"Corbin","year":"2013","journal-title":"J Health Care Poor Underserved"},{"issue":"1","key":"soi260062r4","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1097\/TA.0000000000001306","article-title":"Utility of the injured trauma survivor screen to predict PTSD and depression during hospital admission.","volume":"82","author":"Hunt","year":"2017","journal-title":"J Trauma Acute Care 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