When Julia, a 21-year-old EMT left for work early one October morning she had no idea that day she would be faced with the biggest mental challenge of her career. After receiving a call from dispatch, she and her partner responded lights and sirens to a residence where a young father had taken a full bottle of medication in an attempt to kill himself. As they rushed through the door, she was greeted by scared family members and a crying baby. When she got to the patient, he was semi-conscious and pleading with her to help him. With these feelings and distractions whirling inside her head she and her partner raced against time to get the young father loaded up and delivered to the closest hospital.
Stories like this are not at all uncommon in EMS. One of the most difficult situations that a first responder will ever encounter is a suicide attempt. When training to become an Emergency Medical Dispatcher and reviewing Protocol 25 (Psychiatric/Abnormal Behavior/Suicide Attempt) I remember thinking to myself, can I handle this if it ever comes up? Fortunately, there are some great resources available for first responders that teach us to prepare, channel, and cope with these exact situations.
The CDC determines that each year there are approximately 465,000 people admitted to hospitals due to self-injury. Many of these individuals exhibit signs that they are at risk for suicide well in advance. In most cases people will reach out for help first. Here are a few warning signs that family members and friends can look for if you suspect someone you know may be at risk:
- Talking about having no reason to live or hopelessness.
- Talking about feeling trapped or isolated.
- Irregular sleep patterns.
- Increased use of alcohol and/or drugs.
- Describing themselves as being a burden.
- Frequent mood swings.
- Talking about suicide.
- Purchasing or easy access to weapons.
Suicide attempts are among some of the most dangerous scene calls that an EMS professional will ever respond to. For first responders arriving on scene, the Suicide Prevention Resource Center (SPRC) 2013 recommends following these steps:
- Ensure the safety of everyone present.
- Address any serious medical needs first.
- Establish rapport with the patient.
- Assess the patient.
- Encourage them to talk about how they are feeling.
- Ask the patient if they have experienced any of the suicide warning signs recently.
- Supervise the patient constantly.
- Collect any toxic substances, alcohol, drugs, or medications.
- Transport the patient to the hospital.
The good news in this is that suicide is highly preventable. Often all that is required is just taking the time to listen to a friend or family member who is struggling and letting them know that you care about them and are there for support. Lending a shoulder to lean on not only helps them but it will make you feel good too! The HelpGuide.org has a thoughtful and informative document available to anyone who needs it at: https://www.helpguide.org/articles/suicide-prevention/suicide-prevention.htm#
For all the first responders who would like to know more about their role in suicide prevention, the SPRC offers this excellent guide: https://sprc.org/sites/default/files/resource-program/EMS.pdf