Self Harm Flashcards
What is self harm
Self poisoning/injury regardless of intent
-risk factor for suicide
What are the reasons for self harm
Attempt to end/preserve life
Communicate with others
Secure help/care
Relief from difficult states
How would you triage a self harm patient
ABCDE
If self injury => find ways of closure
If self poisoning => Toxbase for info
Charcoal, gastric lavage, bowel irrigation
What are the antidotes for
- paracetamol
- benzodiazapenes
- Opioids
Paracetamol
-IV acetylcysteine
Benzodiazepines
-Flumenazil
Opioids
-Naloxone
What extra questions would you like to ask in a history
What else would you be looking for?
Drugs, alcohol
Personal Hx
Social Hx
Forensic Hx
Appearance Behaviour Speech Mood Cognitions
What are the static factors for suicide
How would you judge this from the history
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
What are the dynamic factors for suicide
How would you judge this from the history
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
How could you assess the suicide risk
Ideation Intent Planning Access to lethal means Past attempts
How would you manage a patient in the long term
BIOPSYCHOSOCIAL
- Treat MH condition
- Self harm interventions
- Harm reduction
Come up with a care and risk management plan