J Emerg Med. 2025 Nov 7;80:241-251. doi: 10.1016/j.jemermed.2025.10.035. Online ahead of print.
BACKGROUND: Post-traumatic stress disorder (PTSD) is a psychiatric condition that can develop after trauma and imposes substantial, long-term morbidity. Emergency departments (EDs), as the initial point of healthcare contact, can reduce patients’ risk of developing PTSD following trauma exposure through trauma-informed care (TIC). Women face a two- to threefold higher PTSD incidence than men and show distinct symptom patterns, indicating that clinical approaches should be adapted to reflect these differences in trauma response.
OBJECTIVES: To present a narrative review that summarizes current evidence on gender-related differences in early posttraumatic responses, TIC practices feasible in the ED, and pathways that connect ED care to psychiatric and outpatient follow-up.
METHODS: We conducted a narrative literature review to explore current evidence on mitigating PTSD risk through gender-sensitive, TIC approaches in ED settings. Searches were conducted in PubMed, Web of Science, Science Direct, and Open Evidence using terms such as «PTSD,» «acute stress disorder,» «emergency department,» «trauma-informed care,» «gender differences,» «sex differences,» and «trauma patients.» Articles in English published primarily in the last 15 years that focused on adult trauma patients in ED settings and gender-specific outcome or interventions were included. Studies that focused exclusively on military or chronic PTSD were excluded.
DISCUSSION: Women more often present with hyperarousal, intrusive re-experiencing, and interpersonal violence-related trauma, whereas men commonly exhibit dissociation and delayed help seeking. Universal micro practices, such as explicit introductions, consent before contact, plain language explanations, and privacy protection, enhance psychological safety and are particularly protective for women. Brief, validated PTSD risk screeners, electronic health record prompts, concise clinician TIC training, and on demand psychiatric consultation streamline early detection for vulnerable patients without impacting ED workflow.
CONCLUSIONS: Embedding gender-sensitive TIC into routine ED workflows enables PTSD risk identification, reduces re-traumatization, and facilitates prompt linkage to mental health services. Practical communication techniques, efficient screening, and structured referral pathways can empower emergency medicine clinicians to mitigate long-term PTSD sequelae across diverse trauma populations.
PubMed:41319493 | DOI:10.1016/j.jemermed.2025.10.035