Suicide and triage during coronavirus

[Jessica5]

With hospitals getting more and more crowded, would they put somebody who made a suicide attempt at the bottom of the triage pile? Think about it- if they have to choose who to save, shouldn't they be try to save people who actually want to live first?

I'm beginning to to wonder if this is a good time to make a suicide attempt.

 

[Rez_MbChB]

No. triage is about likelihood of survival, not want.

 

[KleinerWolf]

With hospitals getting more and more crowded, would they put somebody who made a suicide attempt at the bottom of the triage pile? Think about it- if they have to choose who to save, shouldn't they be try to save people who actually want to live first?

I'm beginning to to wonder if this is a good time to make a suicide attempt.

If I read the thread correct, what are the reasons that make you want to ctb?

 

[Weightoftheworld]

No. triage is about likelihood of survival, not want.

This is correct. Those more likely to survive are always treated first.

 

[KleinerWolf]

This is correct. Those more likely to survive are always treated first.

Assuming that means emergencies visit get treated first before coronavirus?
I'm not surprised, since in some countries you need booking for coronavirus treatment in the hospital...

 

[Rez_MbChB]

Assuming that means emergencies visit get treated first before coronavirus?
I'm not surprised, since in some countries you need booking for coronavirus treatment in the hospital...

Yes. But corona could cause the patient to be an emergency. I wouldnt treat someone presenting with mild symptoms over a self harm injury with large amounts of blood loss for example, but a stable suicide attempt vs someone going into respiratory arrest (which could be due to corona) I would ET them.

 

[KleinerWolf]

Yes. But corona could cause the patient to be an emergency. I wouldnt treat someone presenting with mild symptoms over a self harm injury with large amounts of blood loss for example, but a stable suicide attempt vs someone going into respiratory arrest (which could be due to corona) I would ET them.

I see how it is.
Thx for clarify.

 

[faust]

Hospitals may have lots of different departments, inf. disease department or how it is called idk can be overcrowded, but cardio can be empty. You probably won't be in same department with covid-19 patients because you may have poisoning or any other thing. However, if your things get worse before they present you to the different department, you may be intubated and hope (or not?) if it is the same building, they have a ventilator.

 

[autumnal]

With hospitals getting more and more crowded, would they put somebody who made a suicide attempt at the bottom of the triage pile? Think about it- if they have to choose who to save, shouldn't they be try to save people who actually want to live first?

I'm beginning to to wonder if this is a good time to make a suicide attempt.

Normal triage is about treating the patients with the most life-threatening injuries first, because they have the most urgent need for treatment.

Reverse triage may be done when there is a severe shortage of resources (such as staff or respirators during the pandemic) and involves treating those who are the most likely to survive (or who have the most potential life ahead of them). This may well involve treating those with the most life-threatening injuries last, or even not at all.

However, neither system involves any moral or subjective considerations like whether the patient wants to live or has attempted suicide.

 

[GoBack]

Corona is always a priority because it's so contagious. A suicide attempt is not contagious. Suicide attempts wait for a long time the ER because they have to be seen by a psychiatrist, that can take hours to find one. They're all so busy doing paperwork these days as well

 

[autumnal]

Corona is always a priority because it's so contagious. A suicide attempt is not contagious. Suicide attempts wait for a long time the ER because they have to be seen by a psychiatrist, that can take hours to find one. They're all so busy doing paperwork these days as well

No, suicide attempts only wait for a long time if the physical injury from the attempt is very minor or just superficial. Or if there is no actual attempt but just suicidal ideation. In which case they are regaded as a mental health emergency, which is triaged lower due to lack of life-threatening status (as long as they aren't deemed an immediate risk to themselves). You are correct however that mental health emergencies do often have to wait a long time both by virtue of triage category but also the wait for an available psychiatric staff member.

If a suspected Coronavirus patient is physically stable, they aren't prioritised by virtue of their potential contagion. They may be moved to a dedicated Coronavirus clinic or otherwise more isolated area, but that is a practical consideration rather than triage decision and doesn't imply that the rest of their assessment or treatment begins at that point or is prioritised over more life-threatening patients without Coronavirus.

 

[Halnas]

I never heard the term reverse triage.
It was always about urgency to see a doctor for us and then the doctor would decide for the treatment and would himself do another triage.
That meant that in the first step the doctor would check out the most sever people first, but that didn't mean that they get the treatment first.
i.e. the most sever possible case is someone who needs to be resuscitation CPR, but the survival chances are so low and it is so intensive on personal (at least 3 people spending 30min before you can reliably declare death), that the doctor might check him out first, but then decides to treat another person, who is actually able to be saved, with higher priority.
The initial triage of who sees the doctor first is not the same as the decision later about who actually gets the treatment first.

And in the case of CoVid, you don't want those contagious people in the same building as others in the first place. So the question of triage doesn't really exist. They don't let them be in the hospital longer than absolutely required. They do not sit together with other people waiting to see a doctor in a hospital which is naturally full of weak and vulnerable people. CoVid infected people are just in the hospital to get the diagnosis and then they get locked in at their home here, till they actually develop an illness that needs and can be treated.
Here in my city there are four hospitals and in case of a more sever outbreak, one of them gets completely focused on CoVid while all others continue business as usual. Until now, having an seperated section for CoVid was enough.

 

[autumnal]

I never heard the term reverse triage.
It was always about urgency to see a doctor for us and then the doctor would decide for the treatment and would himself do another triage.
That meant that in the first step the doctor would check out the most sever people first, but that didn't mean that they get the treatment first.
i.e. the most sever possible case is someone who needs to be resuscitation CPR, but the survival chances are so low and it is so intensive on personal (at least 3 people spending 30min before you can reliably declare death), that the doctor might check him out first, but then decides to treat another person, who is actually able to be saved, with higher priority.
The initial triage of who sees the doctor first is not the same as the decision later about who actually gets the treatment first.

And in the case of CoVid, you don't want those contagious people in the same building as others in the first place. So the question of triage doesn't really exist. They don't let them be in the hospital longer than absolutely required. They do not sit together with other people waiting to see a doctor in a hospital which is naturally full of weak and vulnerable people. CoVid infected people are just in the hospital to get the diagnosis and then they get locked in at their home here, till they actually develop an illness that needs and can be treated.
Here in my city there are four hospitals and in case of a more sever outbreak, one of them gets completely focused on CoVid while all others continue business as usual. Until now, having an seperated section for CoVid was enough.

That's essentially a mixture of standard and reverse triage. If you've never heard the term reverse triage, you're either extremly lucky to have never encountered it, or so unlucky that is the regarded as the standard form of triage where you are. I'm assuming you don't live in a metropolitan area and/or in a developed country?

 

[Halnas]

I'm assuming you don't live in a metropolitan area and/or in a developed country?

Right in the middle of western Europe.
The basic triage where they follow rules to the point is just for First Responders and EMTs here (i guess that is how those guys are called in burger land). The emergency doctor himself is assumed to have experience and he has more freedom and can decide that somebody who is very unlikely to survive, no matter the treatment, is prioritized lower than somebody who can be saved or just gets palliative care, if the resources are limited. And after that the hospital itself does another different triage where surgeries of ordinary non-life-threatened people get delayed in order to treat those.
"Reverse triage" sounds a bit weird to me, because the lowest priority in triage are the people who survive even without treatment and people who are beyond help. I doubt that those get high priority in any triage system.

 

[Frt]

I think urgency doctors and doctors don't care about suicidal people. Cause they think we've looked for what is happening or we're going to start over....:(