Self Harm Flashcards

1
Q

What is self harm

A

Self poisoning/injury regardless of intent

-risk factor for suicide

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2
Q

What are the reasons for self harm

A

Attempt to end/preserve life
Communicate with others
Secure help/care
Relief from difficult states

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3
Q

How would you triage a self harm patient

A

ABCDE

If self injury => find ways of closure
If self poisoning => Toxbase for info
Charcoal, gastric lavage, bowel irrigation

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4
Q

What are the antidotes for

  • paracetamol
  • benzodiazapenes
  • Opioids
A

Paracetamol
-IV acetylcysteine

Benzodiazepines
-Flumenazil

Opioids
-Naloxone

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5
Q

What extra questions would you like to ask in a history

What else would you be looking for?

A

Drugs, alcohol
Personal Hx
Social Hx
Forensic Hx

Appearance
Behaviour
Speech
Mood 
Cognitions
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6
Q

What are the static factors for suicide

How would you judge this from the history

A

PC
-evidence of careful planning/violent methods

Psych Hx

  • self harm
  • MH
  • psych admission

FHx

  • self harm
  • MH
  • suicide

SHx

  • male, increased age
  • separation, divorce, legal troubles
  • physical, sexual abuse
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7
Q

What are the dynamic factors for suicide

How would you judge this from the history

A

PC

  • suicidal ideation/plan
  • MH

Psych Hx

  • poorly optimized MH treatment
  • concurrent physical illness
  • loss of functional independence/impairment

Drug, alcohol
-use, abuse

SHx

  • Marital/family issues
  • Access to method of suicide
  • Live alone, poor social support
  • Exposure to suicidal behavior
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8
Q

How could you assess the suicide risk

A
Ideation
Intent
Planning
Access to lethal means
Past attempts
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9
Q

How would you manage a patient in the long term

A

BIOPSYCHOSOCIAL

  • Treat MH condition
  • Self harm interventions
  • Harm reduction

Come up with a care and risk management plan

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