The emergency department child and adolescent psychiatrist is in the unique position of informing and helping emergency department providers address the traumatic impact of the cause of a child's emergency presentation and the potential iatrogenic exacerbation of the acute traumatic response. The child and adolescent psychiatrist must become a clinical traumatologist who provides the necessary consultation and education that lead to practice change in emergency department awareness and procedures and performs the optimal evaluation and interventions for children who present in psychiatric crisis.