Even in the hectic atmosphere of the Pediatric Emergency Department, Kirsten A. Bechtel, MD, who specializes in forensic medicine and child abuse, strives to never interrupt her patients or their caregivers.
“I like to ask open-ended questions and just let people talk. As health care providers, we can be so task-oriented and have to check off all of our boxes, it ends up being more of a transaction with a patient rather than a relationship,” she says. “So, I say, ‘Tell me everything that is going on.’ By not saying anything until they finish talking, you get an idea of what the real issues are.”
The Pediatric Emergency Department at Yale New Haven Children’s Hospital (YNHCH) is a Level 1 trauma center and has exceptional subspecialty care for vulnerable children, such as those who have experienced abuse and neglect, sexual assault, domestic minor sex trafficking, and behavioral health emergencies, Dr. Bechtel says. “We know that the fewer adverse childhood experiences kids have, the more likely they will grow up to be productive, positive adults, which makes trying to recognize abuse, report it, and protect the child vital,” she adds.
The ED can be a difficult place for families, too, and Dr. Bechtel tries to reassure parents, telling them, “You are doing a beautiful job with this child. You just need a little help right now, and I am going to provide that.”
Dr. Bechtel ensures families are comfortable during ED visits, offering warm blankets and pillows, hot beverages, popsicles for the patients and their siblings, and activities such as coloring or blowing bubbles.
She is the co-medical director of the Injury Free Coalition for Kids at YNHCH. “This includes trying to prevent child abuse, medical injuries, or behavioral health injuries,” she explains. “Post-traumatic stress symptoms can be disabling to kids after they’ve gone through a traumatic event. We also look into trends in pedestrian and bicycle safety.”
Dr. Bechtel is an associate professor of pediatrics and of emergency medicine at Yale School of Medicine.