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Old 05-09-2012
tyagee's Avatar
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Psyche What is the best management of this suicidal 16 year old girl?

A 16-year-old girl is brought to the emergency department after her parents find her in her bedroom, attempting to cut her wrists. Examination finds a number of superficial cuts and a deeper one-centimeter laceration that requires two sutures. The patient admits to cutting her wrist, but when asked why she did it, she states, "I don't know." She avoids eye contact and looks at the ground for the entire interview. She refuses to answer many questions, but admits to feeling depressed over the past few months. She denies any past psychiatric history. When asked if she would do something like this again, the patient is quiet for some time, and then shakes her head. When the parents are approached about their daughter, they state they want to bring her to her pediatrician, who they trust, and who knows her very well. They insist that they will watch their daughter all the time, and feel she will be fine.
What course of action is most appropriate?

A. Discharge the patient home with her parents.
B. Discharge the patient home with her parents after they sign a form indicating they will take all responsibility for monitoring their daughter.
C. Hold the patient in the emergency department overnight for re-evaluation in the morning.
D. Hold the patient in the emergency department until the patient's pediatrician can be reached and an appointment confirmed within the next few days.
E. Admit the patient to the hospital, involuntarily if necessary.

Explanation:
had this patient not been minor then what was the answer?
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Old 05-09-2012
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Quote:
Originally Posted by tyagee View Post
A 16-year-old girl is brought to the emergency department after her parents find her in her bedroom, attempting to cut her wrists. Examination finds a number of superficial cuts and a deeper one-centimeter laceration that requires two sutures. ....................When the parents are approached about their daughter, they state they want to bring her to her pediatrician, who they trust, and who knows her very well. They insist that they will watch their daughter all the time, and feel she will be fine.
What course of action is most appropriate?
any suicidal patient must be admitted to the hospital for observation. I dont think it is different for adolescents or adults. Even if the patient refuses.
I am a little confused about D-- but even then if u can make an appointment with the pediatrician .. u cannot guarantee that the girl will not attempt again.
hence i think E is correct
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