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In the event that an ED physician is evaluating and managing a truly
homicidal patient, the ED physician has a duty to both warn the potential
victim (typically via contacting local police) and to take actions to protect
the potential victim from harm (e.g., by psychiatrically hospitalizing the
patient). This duty was established in the landmark case of Tarasoff vs. the
University of California and has withstood numerous court challenges. This
duty to warn and protect the potential victim supersedes the physician’s duty
to maintain patient confidentiality.
SUICIDE ATTEMPTS
Goals of Emergency Evaluation and Treatment
The goals of emergency evaluation and treatment of patients presenting in
the wake of a suicide attempt are to identify and treat any potential medical
sequelae of the attempt, to maintain the patient’s safety in the ED, and to
establish an adequate disposition plan.
CLINICAL PEARLS AND PITFALLS