TABLE 5.

Trauma-informed care practices as applied to patient examination procedures (adapted from Elliot et al²⁵)

Prior to examinationa	Obtain consent: provide patient with a choice of whether or not to proceed with exam, and medical rationale for why it may be helpful Provide details and parameters of exam, such as specific procedures, timeframe, duration, and objective Ask if patient would like a support person present Ask if steps can be taken to increase comfort Provide patient with choice about clothing, body position, use of stirrups Establish a verbal (word) or non-verbal (foot wiggle, arm raising) signal to indicate stopping the exam, when medically possible Allow patient to ask questions and clarify as able Develop a plan of active coping techniques to use during the examination (eg, deep breathing)
During examination	Inform patient when examination is starting Check-in with patient regularly Speak in a calm voice Continue to remind patient of parameters, such as the steps you are taking during the exam Maintain awareness of signal and respect patient’s wishes if stopping is requested. In the event that this is not medically safe, inform the patient that the examination will cease as soon as you are able Encourage and reinforce active coping techniques
After examination	Encourage and reinforce active coping techniques Summarize findings, write them down for the patient if possible Allow patient to ask further questions

^aThe care practices suggested above in examinations are interchangeable with diagnostic testing, treatment, and procedures.