CRACKCast E115 - Suicide - a podcast by The CanadiEM.org Team

from 2017-10-05T12:00

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This episode covers Chapter 105 of Rosen’s Emergency Medicine (9th Ed.), Suicide.

Episode Overview:

Suicide is a common but preventable cause of death
Suicide is usually triggered by treatable or reversible short-term crises
Most attempted suicide survivors are grateful to be alive
Suicide risk changes over time; estimations of imminent risk are NOT evidence-based
Routine screening labs provide little value to most ED patients with self-harm behaviours
Evaluations should be targeted to signs or symptoms of disease on presentation
Any ED visit for suicidal thoughts or behaviours represents a crisis and a teachable moment
- With your approach, it is important to be supportive, empathetic, and patient-centred
- Have a collaborative plan that integrates the input from collateral sources
When caring for suicidal patients, use precautions:
- Sitters
- Physical/chemical restraints
- Involuntary admission forms
Brief and focused risk assessment of patients in the ED can identify persons in need of further comprehensive evaluation and consultation with a mental health specialist
Those patients who are deemed to be at low-risk of suicide may be discharged home to a safe and supportive environment, assuming they have no access to toxic medications or guns
- They should receive education and safety planning in the ED
- They should have early mental follow-up appointments

Core questions:

Name 10 risk factors for suicide
Name an additional 5 risk factors for adolescent suicide
Describe the SAD PERSONS Scale
Describe 4 potential targeted investigations for patients presenting to the ED with suicide
Name 3 protective factors for against suicide