Apparent suicide call...

[NJN]

Dispatched to an apparent suicide. On scene you find a male hanging by shoestring. You go to check for vitals and he is still warm, with no definitive signs of death.

Now the question, do you work a code or call them ME?

 

[Hastings]

Dispatched to an apparent suicide. On scene you find a male hanging by shoestring. You go to check for vitals and he is still warm, with no definitive signs of death.

Now the question, do you work a code or call them ME?

Seriously?

...You work the Hell out of him.

Grab the knife out of your pocket and cut the guy down first, though.





...What were my vitals? What do you mean he has no definitive signs of death? Does he have a pulse? That's a nice start.

1. Assess scene.
2. Cut patient down, lower to floor.
3. Check ABCs.
4. If no breathing, bag, lots of O2. If no pulse, CPR. If either, move to 5.
5. EKG, shock if necessary. If not indicated, intubate.
6. Continue arrest scenario.

Also, since it's a shoe string (wow, strong shoe string), could be as simple as asphyxiation. Oxygen and intubation IMMEDIATELY. Try to assess timeframe by any bystanders. Cyanotic?

There are two ways of dying from hanging, I believe. Breaking the neck on initial drop and asphyxiation. The former seems unlikely by shoe string. If intervention early, asphyxiation can be fixed. Get right on it.



Call the cops if they aren't already there though.

 

[NJN]

No Pulse, but still warm.

 

[Hastings]

No Pulse, but still warm.

There's no question. Not breathing, I assume? Cut him down and follow arrest protocols.

CPR, Assess Rhythm, Shock if indicated, Intubate, Drugs if indicated, Repeat for - in my opinion in a suicide of this type - for at least 45 minutes. This is not the type of call to give up in unless there are VERY definitive signs of death. In comparison to other suicide scenarios, this one has a significantly better chance. Especially if young.

 

[NJN]

BTW this was taken from an episode of "Cops".

 

[KEVD18]

i'd have to work the arrest, but i wouldnt kill myself over it.(no pun intended)

follow the code algortihms, indicate during my entry notifications to the ed that this was a suicide and not be a bit suprised when they call it upon arrival.

heres where the wheels fall off of this call for me. they tried to kill themselves. i dont really have the capacity to pour my soul into someone who has no interest in their own life. i'll follow the book, but im not terribly concerned over the matter.

 

[firecoins]

great! COPS.

 

[Hastings]

BTW this was taken from an episode of "Cops".

Had a similar experience myself. Although in mine, there was an officer within the area when the patient attempted it. He was cut down within 1 minute and a half, and had no complaints other than a nasty mark and neck pain upon our arrival.

But yes, never ever declare a suicide by hanging an unworkable situation. In fact, most suicides should be worked, despite how hopeless they may appear. The only exception I can think of is the removal of the brain by gunshot.

I will not work a drug overdose or hanging for less than 45 minutes unless the patient is in rigor. And clearly, that was not the case here. Work it. Work the Hell out of it.

 

[Jon]

The discussion we had in Chat that precipitated this was: you arrive first and find someone "hanging out".

Do you cut them down, or leave them hanging.


My take - this is a non-issue. Usually, if they are found by family/roommates, the roommates cut them down and then we may, or may not work them.

Also... if I'm dispatched for an attempted suicide... I'm staging for PD to clear the scene.

If they have been cut down, and they aren't being worked - we either find obvious signs of death... or we will work it. If someone else started working it... then we usually continue, at least until we hit the point in the ALS algorithm to call it.

If they are still hanging by the time we get there... it is usually because they are VERY "obvious"... Us and/or the PD then contact the ME.

 

[Hastings]

The discussion we had in Chat that precipitated this was: you arrive first and find someone "hanging out".

Do you cut them down, or leave them hanging.


My take - this is a non-issue. Usually, if they are found by family/roommates, the roommates cut them down and then we may, or may not work them.

Also... if I'm dispatched for an attempted suicide... I'm staging for PD to clear the scene.


If they are still hanging by the time we get there... they are usually BEYOND "obvious"... Us and/or the PD contact the ME.

There is absolutely no reason to leave them hanging. None at all. Cut the rope. The remaining hanging rope and the marks around the patient's neck are enough for the police and ME to put things together, and it's your absolute responsibility to work any patient that doesn't have ABSOLUTE signs of death.

Again, the only patient I've ever not worked was a woman we found lying on her bed next to a crack pipe and ball of crack cocaine. She was ice cold and in rigor.

But warm and of suspected suicide? There's just no question. None at all. Cut them down IMMEDIATELY and get to work.

 

[Ridryder911]

Well since they are only hanging on by threads, it all depends upon on "how dead" they are.

Never seen where there is any difference or differential in determining to work a suicide any differently than any other causative agent (except TSA Od's.) Dead is dead.

If there is any sign of levity, and no pulse, I call it. It takes a while to blood to pool and as well all the other indicators of hypoxia, potential cervical injuries..

If I did call it, then yes I leave them hanging.. it is a crime scene. By cutting them down you destroyed the scene.

The main thing about cutting them down, if you are going to work them, is to cut as near the tied end or through the loop if it is taught....NEVER cut through the knot!.. CSI will have your arse. Knots can be reviewed if they were self or by another person, etc.

Remembering all deaths are homicide until proven otherwise.

 

[mycrofft]

"How dead". Miracle Max from Princess Bride?

I say if he's hanging by a shoelace, pull the shoe all the way off and he'll just drop.Hanging upside down...how distressing.

One spring night a guy went into a little wooded lot (about seventy by seventy) in the middle of a heavily travelled intersection and hanged himself in a copse of boxelders and silver maples. No one knew he was there until road crews came to clean out the leaves in September. Thousands of cars driving by within two hundred feet every day. Uh, don't work THAT one!

 

[reaper]

Dispatched to an apparent suicide. On scene you find a male hanging by shoestring. You go to check for vitals and he is still warm, with no definitive signs of death.

Now the question, do you work a code or call them ME?

Leave and come back later, You got there to quick!

 

[firecoins]

Well since they are only hanging on by threads, it all depends upon on "how dead" they are.
.

Yes he could be partially dead. He clearly said "to blave" which we know means to bluff so clearly he owed money.

 

[mycrofft]

But the mutton can't be too tender..little MLT sandwich there....

Sportsfans, it's good to be alive.

 

[SmokeyBear]

BTW this was taken from an episode of "Cops".

Never watched COPS and this may be off topic but, what happened in the episode? They didn't leave the poor slub hanging there did they?! :blink:

 

[NJN]

The PD were the ones who checked for the pulse. They left him hanging until the ME arrived. This happened late at night so no civilians were around to gawk.

 

[Ridryder911]

If you have determined not to work the victim, then its a crime scene and leave it alone. The body is not going anywhere or going to change in a few minutes it takes for the CSI and ME to arrive. It is no longer your job or position.

 

[medic_chick87]

Yes he could be partially dead. He clearly said "to blave" which we know means to bluff so clearly he owed money.

Firecoins, you rock!
Love The Princess Bride

 

[mikie]

I'd like to know how high he is hanging. If you cut him loose, are you planing on catching him, or letting him hit the ground then having to board/collar him?