CRACKCast E115 - Suicide

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