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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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viernes, 25 de noviembre de 2016

Suicidal Patient

emDocs - November 25, 2016 - Author: Simon E - Edited by: Koyfman A
"Key Pearls
  • Stabilize as appropriate => a number of patients will present after performing self-harm
  • If the patient is hemodynamically unstable, consider an EKG to evaluate for sodium channel blockade (TCA overdose)
    • Quickly evaluate for signs/symptoms of toxic ingestions
  • In the stable patient, perform an H&P focusing on risk factors for suicide
    • Question patients regarding substance abuse (specifically alcohol)
    • Question regarding access to weapons
    • Use friends/family to corroborate stories
  • During the physical examination, evaluate for findings consistent with toxidromes or organic pathology
  • After seeking out organic etiologies of suicidal ideation, medically clear the patient and consult a specialist
  • Be familiar with state laws regarding emergency detention
  • Avoid the use of safety contracts in the emergency setting"