Family history of suicide

Sassafras

Sassafras

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Did interfacility psych transport for girl who tried to cut wrists (albeit very uneffectively but tried none the less). Hospital records state father is deceased due to suicide. For a psych transport this seems like relevent medical history but it's not HER history. Do I provide this information in the trip sheet? (Patient did not seem to realize dad was dead as she calls step father dad and doesn't remember a time he wasn't in her life so we did not tip her off to that information).
 
There's nothing wrong with including pertinent family history in the chart. Wouldn't family cardiac history be approprit to include? Is the concern over the psych component?
 
Actually, no. The concern is that there just doesn't seem to be an appropriate place to put this information as there is no "family medical history" option in our computerized charts. I guess I would place it in my narrative? Under HPI? PMH?
 
Sassafras said:
Actually, no. The concern is that there just doesn't seem to be an appropriate place to put this information as there is no "family medical history" option in our computerized charts. I guess I would place it in my narrative? Under HPI? PMH?
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PMH. Note it as "family history of suicide, biological father"
 
One of the facilities we contract with deals specifically with kids with psych issues. The majority of our calls come out of there. While the usual case is the parents are completely out of the picture; however I have run in to your situation. I documented it in my narrative under the H in CHART. I'm not saying this is the right or wrong way to do it, just telling what I've done.
 
This one actually had me questioning things and comparing my old job in mental health with EMS. Parents not there. Hospital transferred care. In mental health at age 14 they are able to sign for themselves in our state. They can also refuse treatment. Parents have no right to the information discussed with therapists.

In EMS, unless they are emancipated or pregnant, under 18 we need parental permission to treat (unless they are in a life threatening situation and parents are no present). I was in a quandry as to if we could even transport this patient.

And it threw me that she didn't know her father had killed himself. But apparently through round about questions I was able to deduce step dad had been aroud for as long as she could remember. So perhaps that's why she didn't know. I did not let her know that information about her biological father though. I felt it was not my place.
 
If it is applicable to the future care of the patient and you catch it, document it. There is a slightly higher suicide rate amongst people whose blood relatives have done the same; therefore, this info is pertinent.

And, I agree, not much value in mentioning: "This is interesting, your Dad made it work!"
 
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Sassafras said:
Did interfacility psych transport for girl who tried to cut wrists (albeit very uneffectively but tried none the less). Hospital records state father is deceased due to suicide. For a psych transport this seems like relevent medical history but it's not HER history. Do I provide this information in the trip sheet? (Patient did not seem to realize dad was dead as she calls step father dad and doesn't remember a time he wasn't in her life so we did not tip her off to that information).
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The history is not "her" medical history but, as a treating physician, it may be a piece of useful inofrmation when found in a patient chart. Not necessary to put it on your trip sheet.
 
albeit very uneffectively but tried none the less
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This sort of crap and the aftermath of dealing with patients like the one described are one reason why I've joked about writing a book to sell at Hot Topic called "The 'Depressed' Teenage Girl's Guide to The Vascular System".

Chapter #1: If it's not above the knee or elbow, you're a cutter, not a suicide attempt."

Think of it as a "pseudo-Goth" version of that old sardonic joke about how protocols should involve giving suicidal patients a Judas Priest album* and/or a subscription to Guns and Ammo.


PMH. Note it as "family history of suicide, biological father"
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What he said.





*-If you're not old enough to get the Judas Priest reference: http://en.wikipedia.org/wiki/Judas_Priest#Subliminal_message_trial
 
I don't tend to joke about these things because I know how these kids struggle but this one was just. ... Sigh.

If you're gonna cut your wrist grab something sharper than a Christmas ornament hook. You'll maybe draw some blood then. I personally don't count it as a suicide attempt or even cutting attemp. I call it angry rage of an ODD child that grabbed the closest thing she could in a fit of "IDONTKNOWWHATTODOWITHMYSELF" it could have been handled much more effectively if mom had wrap around services instead of mom rushi
 
Instead of mom rushing to ER is what I was typing before my toddler hit submit on my phone and now it won't let me edit. LOL
 
cutter

Chapter #1: If it's not above the knee or elbow, you're a cutter, not a suicide attempt."

This is exactly what I thought as soon as I read the original post. Being a foster parent in the recent past, I dealt with alot of "cutters" and it was quite common to use paper clips, pens and pencils, any little piece of glass or metal in the yard, etc. Not that the parents suicide wouldnt be good info to have, but this young lady sounds like a troubled cutter. :sad:


Carie
 
Troubled yes. Potential cutter maybe but currently, the way it transpired I'm negating the term cutter for this young lady. It was a first time offense and with the right intervention it won't get any more intense than this moment.
 
I call it angry rage of an ODD child that grabbed the closest thing she could in a fit of "IDONTKNOWWHATTODOWITHMYSELF" it could have been handled much more effectively if mom had wrap around services instead of mom rushing to ER
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Those sort of kids are one major reason why I argue for a return to the institutionalization standard of care for incurable and largely untreatable psych cases (ODD, severe and low-functioning autism, severe Downs syndrome, schizophrenia, etc).
 
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