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Suicide, Risk Evaluation, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • The intentional taking of one's own life

  • Suicidal ideation:

    • Passive: A conscious desire not to live

    • Active: Intention to die with or without a plan

  • Parasuicidal behavior: Self-injury not...

Diagnosis

Signs and Symptoms

  • Depressed mood

  • Verbalization of suicidal ideation with or without plan

  • Hopelessness

  • Helplessness

  • Anger/aggression

  • Impulsivity

  • Psychotic symptoms (i.e., paranoia, command auditory...

Treatment

Pre-Hospital

  • For potentially dangerous patient who refuses transport to treatment facility; involve police and impose restraint.

  • Risk to medics on the scene in cases of firearms or other weapo...

Follow-Up

Disposition

Admission Criteria

  • If patient endorses suicidal ideation with plan and intent, admission may be needed for safety.

  • If impulsivity, anger, or aggression hinder ability to control beh...

Pearls and Pitfalls

  • A careful history will identify risk factors for suicide.

  • Access collateral sources of information about patient's recent thoughts and behavior.

  • Maintain patient safety during evalua...

Additional Reading

  • Ali  A, Hassiotis  A. Deliberate self harm and assessing suicidal risk. Br J Hosp Med (Lond).  2006;67(11):M212–M213.

  • Cooper  JB, Lawlor  MP, Hiroeh  U, et al. Factors that infl...

Codes

ICD9

  • 311 Depressive disorder, not elsewhere classified

  • V17.0 Family history of psychiatric condition

  • V62.84 Suicidal ideation

  • 300.9 Unspecified nonpsychotic mental disorder

ICD10

  • R45.851 Suicidal idea...

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