Suicide is a leading cause of death among youth, and the emergency department (ED) serves as the primary point of healthcare contact for many with suicidal ideation. As suicide-related presentations to the ED continue to rise, the implementation of time- and cost-effective care pathways becomes ever more critical. Evidence-based tools for the identification and stratification of suicide risk can aid in clinical decision-making and care linkage.
Our recent issue Evaluation and Management of Suicidal Ideation and Self-Harm in Children in the Emergency Department reviews best practices for suicide risk assessment of youth to guide evaluation, management, and disposition planning within the ED setting.
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Here are a few key points:
- Evaluation of youth with suicidal ideation should include a detailed review of the presenting chief complaint, as well as identification of co-occurring conditions that require active emergency department (ED) management.
- Thorough review of systems and subtle physical examination findings can help differentiate specific toxidromes or medical conditions that may mimic symptoms of depression.
- Children with intellectual disabilities and autism spectrum disorder who present with self-injurious behaviors require a careful history and physical examination, as these behaviors may represent a manifestation of pain.
- Appropriately trained ED staff are integral to maintaining a safe, therapeutic environment for children with suicidal ideation and self-harm. Training programs in trauma-informed care, crisis response, and de-escalation techniques can improve staff knowledge, confidence, and decrease staff injury.
Read the full issue and earn 4 AMA PRA Category 1 Credits™.