Pediatric emergency medicine trisk 4175 4175
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use a family member’s firearm. Of those, over two-thirds used guns
that were unlocked and the remainder either knew how to open the
gun safe or were able to break in. In one study, nearly a quarter of
children whose parents believed they had never handled their
firearms were mistaken. Removal of firearms (and potentially
dangerous medications) from the home—at least temporarily—is
ideal; safe storage is a minimum.
The dichotomy sometimes drawn between suicide “attempts” and
suicide “gestures” is ill conceived, and the lethality of attempt does
not always correlate with lethality of intent. As a corollary, minimizing
a suicidal act as “just cry for help” by not responding adequately only
invites a potentially far-more-lethal “scream for help.”
Suicidal ideation is common enough that EDs could consider
screening all teens for suicidal ideations or attempts, especially ones
engaging in any high-risk behaviors or with other identifiable risk
factors. Several screening tools, such as the Risk of Suicide
Questionnaire (RSQ) and briefer two- and four-question screening
tools are effective and accurate in screening for suicidality in
patients presenting with nonpsychiatric complaints. Other wellvalidated pediatric suicide screening tools include the “Ask SuicideScreening Questions” (ASQ,
) and the Columbia Suicide Severity
Rating Scale (C-SSRS, ). The AACAP
Suicide Resource Center can be accessed at
/>Suicide_Resource_Center/Home.aspx
