Next up in the news is a look at how we handle depressed and suicidal patients in the type of history taking questions we ask and should be asking them. A study from the University of Colorado School of Medicine says that many emergency department staff members, physicians and nurses, failed to follow up and ask if suicidal patients have access to firearms in their home or vicinity when they’re not in the emergency department.
Misconceptions About Suicidal Patients
The study also revealed a common misconception that perhaps suicidal patients would succeed no matter what their access to weapons is. About 44% of physicians and 67% of nurses believed that those who committed suicide would find a way to do it regardless of their access to firearms.
What kind of questions do you ask your patience when you respond to a behavioral patient who is suggested that they wanted to harm themselves or others? Do you ask them if they have a weapon on their person or access to a weapon in their home? These are the kinds of questions that we should be asking, not because it’s part of a national firearms control debate, but because it just makes good sense as a healthcare professional when taking care of our patients.
Assessing and Managing Suicide Attempts
While this study looked at emergency department staff I think it warrants a look at how emergency responders in the back of ambulance and in people’s homes deal with whether patients have access to firearms. We need to pass this information along to the emergency department staff with the goal of helping the patient safely manage their access to firearms.
I have been in a situation where I have had a behavioral patient in the back mandolins revealed to me that they had a knife on their person and it scared the heck out of me. You should make this part of your standard assessment, ideally before you ever leave the scene and begin transport, because you don’t want to be trapped in the back of an ambulance with a patient who has a weapon on their person.
Scene Safety Extends Beyond Visible Hazards
Now obviously my situation turned out okay but it could just as easily have gone wrong and I would’ve been unnecessarily surprised. The patient volunteered the information in the course of a conversation on route to the hospital but it revealed to me a hole in my assessment and history taking that I have made part of it since. The simple question “Do you have any weapons on you or nearby?” is one that every EMT and paramedic should include in their standard assessment for behavioral and suicidal patients.
Remember, scene safety doesn’t end with what we can obviously see. It extends to any potential threats as well.
Follow-up on the link for this and other news items as well as all of the additional resource links in the show notes for this episode – Mobile Pulse Ox for Your Phone and Episode 330.