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  #1  
Old 05-14-2012
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Question suicide attempt...next step...reason pls.

A 22-year-old woman is seen in the emergency room after a suicide
attempt. She swallowed 10 aspirin in the presence of her mother, with
whom she had just had an argument. The patient has a long history of cutting
herself superficially with razor blades, which her psychiatrist of the
last 5 years confirms by telephone. The patient currently lives in a stable
environment (a halfway house) where she has been for 3 years. Which of
the following option is the best course of action for the physician in the
emergency room?
a. Admit the patient involuntarily
b. Admit the patient voluntarily
c. Admit the patient to a medical floor
d. Discharge the patient to outpatient therapy after meeting with the patient’s
mother
e. Discharge the patient back to outpatient therapy and the halfway house


compare with this q [--had posted earlier--]
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.

what u think is best ans?
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  #2  
Old 05-14-2012
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Default suice step

patients who are acute threat to themselves must be admitted involuntary if necessary,even for minors against parents wishes.

In 2nd Q the answer is E
and same should apply for 1st too I think!!!!
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Old 05-14-2012
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in the first question i think the girl is just threatening her parent of suicide, cuz if u notice the first time she had SUPERFICIAL cuts and now ONLY 10 of Asa "in the presence of her mother", SO i think the ans is D (but the stable environment issue ?? i dont know to relate it anyway)

in the second question, i think ABUSE & suicidal attempt, so i go with E
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Old 05-14-2012
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irrespective of whether for attention or an actual life threatening probability.

ADMIT IF SUICIDE ATTEMPT.

for both questions

reasoning---
she swallowed 10 aspirins--- they didnt tell u of what strength. how many mg?
if its baby aspirin it'll be just 800mg total dose.. but if its the proper tablet it'll be about 5000mg/5gm... that is alot!
unless CLEAR INFO IS GIVEN. DONT ASSUME. (made alot of mistakes in step 1 assuming stuff too)

2ndly--- superficial cuts cud be ---either attention seeking.. or HESITATION wounds.. which wud eventually lead the patient to cut herself deeply.
again DONT ASSUME.
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  #5  
Old 05-14-2012
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Quote:
Originally Posted by bisho View Post
in the first question i think the girl is just threatening her parent of suicide, cuz if u notice the first time she had SUPERFICIAL cuts and now ONLY 10 of Asa "in the presence of her mother", SO i think the ans is D (but the stable environment issue ?? i dont know to relate it anyway)

in the second question, i think ABUSE & suicidal attempt, so i go with E

-yes i agree,when pt take asp infront of her mom she know that her mom will bring her to er&shewill be safe.
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Old 05-14-2012
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so whats the answer?
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