Boudreaux et al reported the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) for evaluating a patient in the Emergency Department. One component is a screening tool that can help to identify a patient who may be at risk for suicide. The authors are from multiple institutions in the United States and NIH.
Screen by nurse:
(1) Over the past 2 weeks felt down, depressed or hopeless?
(2) Over the past 2 weeks had thoughts of killing self?
(3) Ever attempted to kill self?
(4) (If item 3 answered Yes) When did this last happen?
Responses for questions 1 to 3: Yes, No, Unable to complete
Responses to question 4: within past 24 hours, within past month, between 1 to 6 months ago, more than 6 months ago
Screen by physician:
(1) active suicide ideation AND past attempt
(2) suicide plan begun
(3) recent intent to act on ideation?
(4) ever had a psychiatric hospitalization
(5) pattern of excessive substance use?
(6) patient irritable, agitated or aggressive?
Responses: Yes, No, Refused, Unable to complete
If any of the physician screening questions are "Yes", then the physician should consider consulting a mental health professional.
