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The psychological and emotional harm of restraining a child during a medical procedure is causing more trauma than necessary.

Dr. Karin Plummer, from Griffith University's School of Nursing and Midwifery, has called for the need for a fundamental rethink of medical practices using trauma-informed care.

The editorial "Rethinking procedural holding through a trauma-informed lens" has been published in the Journal of Pediatric Nursing.

"We should be teaching our medical professionals that children need the key principles of safety, trust, collaboration, empowerment and cultural sensitivity during any medical procedure, " Dr. Plummer said.

"In the clinical environment, trauma-informed procedural care begins before the procedure by providing honest, age-appropriate communication to reduce the child's anxiety.

"During procedures, strategies such as comfort positioning, distraction techniques, and the use of topical anesthetics can significantly lower pain and distress, reducing the likelihood of restraint altogether.

"After procedures, reinforcing children's coping efforts, allowing for recovery time and debriefing, supports emotional regulation and resilience, which are key to shaping positive future health care experiences."

The current routine practices within pediatric care are now considered to be unwise, unacceptable, and unethical.

Dr. Plummer found that despite the increased recognition of children's rights and the principles of trauma-informed care, restraining a child was still a commonly used practice during medical procedures.

"In some cases, children are being held down against their will, sometimes by multiple adults, which is ultimately creating these feelings of panic, fear, anger, and betrayal, " she said.

"Many of these children have expressed a sense of invisibility and powerlessness, reporting that their voices were ignored during these experiences and, for some, these encounters have left deep emotional scars.

"It's unfortunate, but the majority of health care providers have no formal training in procedural holding and child assent, resulting in these traumatic events for the kids, the parents and the health care providers."

According to an international survey, 81% of child health care professionals use physical support to comfort children during procedures, typically involving parents and nursing staff.

More information: K. Plummer et al, Rethinking procedural holding through a trauma-informed lens, Journal of Pediatric Nursing (2025). DOI: 10.1016/j.pedn.2025.05.029