Be aware of conan signs which may indicate thatthe individual may commit suicide, such ‘Suicidal ehreat Writing farewell eters Giving way weasured articles Making il Cosing benk accounts Appearing peacefil and happy aftera period of depression Refasing to eat or dink, maintain personal hygiene, “Monitor the patients safety needs: ‘+ Take all suicidal treats or atempys seriously and notify psyehiats. ‘+ Search for toxic agents suchas drugs leohol 1+ Do not leave the drug tray within reach of the patient, make sure that the daily medication is swallowed, Remove sharp instruments such as razor, blades, knives, pass bottles fom his ‘Remove straps and clothing such as bolts, neckties. Do not allow the patient 19 bolt his door oa the inside, make sure that somebody accompanies him the bathroom. Patient should be kept in constant observation and should naver be lef alone. Have good vigilance especially during morning hous, ‘Spend time with hi, talk to him, and allow him to ventilate his eeings, Encourage him to talk abou his suicidal Plans! methods suicidal tendencies are very severe, sedation shoud be given as presribed, Encourage verbal communication of suicidal ideas as well 8s his) her fear and depressive thous. Enhance self-esteem of the patient by focusing on his stengths rather than weaknesses. His postive qualities should be emphasized with realistic praise and {pprecation. This fosters «sense of selfworth and enables him to wake contol of his fe siustion MANAGEMENT OF ATTEMPTED SUICIDE ‘+ Assess for vital signs, check ainvay, if necessary clear airway ‘© Itpulse is weak, stat TV fds, ‘+ Tum patient's head and neck to one sid to prevent reguritation and swallowing of Emergency measures to be insted in case of selinvicted injuries MANAGEMENT OF sHock “Transfer he patent vo medical centre immediately there is no evience of lif, leave the body in the sme postion/room in which it vas found (move the patient incase suicide from a common living area for example, dining room or TY room) Infoum aunbortes, record the incident acurately ‘Once the patent is transfered to mortuary or police custody clean the ple with disinfectant soliton 2. VIOLENT OR AGGRESSIVE BEHAVIOR OR EXCITEMENT ‘This is a severe form of aggressiveness. During this stage, patient will be ination, uncooperative, delusional and assauive ‘AEriovogy: + Organic psychiatie disorders lke, delirium, dementia, Wernicke-Korsakofs synitome or psychosis + Other psychiatric disorders ike, schizophrenia, mania, agitated depression, withdrawal fiom alcohol and drugs, eplepss, acute sites reaction, pani disorder and personality disorders ‘MANAGEMENT An excited patin is usually brought ted! up with a rope oF in chains. The ist step shouldbe to remove the chains. large proportion of agaression and violence is due tothe patent fooling humiliated at beng tied up inthis manner, ‘Talk tothe pationtand see if he responds. Firm and kind approach is essential, Usually sedation is given. Common drugs used are: diazepam 10-20 mg IV; haloperidol 10.20 mg; chlorpromazine 30-100 mg IM according 10 clinical jindgeme nt (Once the patients sedate, arrange the patient fo err che referral is nt feasible, following measites soa he taken + In particular check for history of convulsions, fever, recent intake of alcohol, Muctatons of consciousness. Carryout complete physical examination Send blood speimens for Haemoglobin, total cell count, te. Look for evidence of dehydration and malmutriton, If there is severe dehydration, IV dip may be stated Have less fumture in the room and remove sharp instruments, ropes, glass items ties strings, match Boxes, et, fiom pation’ vicinity, Keep environnent stimuli, such as lightning and noise levels to a minimum; assum a single oom: limit interaction wih thers, Remove hzanous objects and substances; caution the patent when there is possibility of ax accidem,