Suicide touches all parts of society. It includes all racial, ethnic, and religious groups in all parts of the world. Suicide is one of the leading causes of death worldwide.
- A national survey found that there are about 129 suicide cases on average every day.
- For every suicide, there are about 25 more attempts.
- Rates of suicidal ideation and suicide attempts were higher during lockdowns in 2020 than in 2019.
- Suicide rates were higher in males than in females in almost all countries. The exceptions are China, Cuba, Ecuador, El Salvador, and Sri Lanka, where the female suicide rate is higher than male.
- The highest suicide rate was among adults between the ages of 45 and 54, and people 70 and above.
As attempted suicide injuries increase, so does the need to learn first aid. As a first responder, you have a vital role in addressing immediate medical needs. While providing first aid, you can also provide clarity and support to the victim and other people at the scene.
The following first-aid recommendations are for the most common methods of a suicide attempt.
First Aid for Gunshot Wound
A self-inflicted gunshot wound is the most common method of death by suicide. It accounts for a little more than half of all suicide deaths yearly.
Head trauma from a gunshot wound is fatal in almost 90 percent of cases. Many victims from gunshot wounds to the head die prior to arrival at the hospital. The 50 percent of survivors from the initial trauma eventually die in the emergency department.
Head trauma from a gunshot wound is the cause of approximately 35 percent of deaths attributed to traumatic brain injury.
The following are general guidelines on how to approach a gunshot wound in the head and other areas of the body.
- Assess the scene. Once you ensure things are safe, immediately call emergency medical services.
- Locate the source of the bleeding. Try to remove the clothing over the wound to see the injury.
- Stop the bleeding. Apply pressure to the wound area in an attempt to stop blood flow. If there is blood coming out of the gunshot hole, put steady pressure on it. Use both hands and start pushing down as hard as you can.
- Use a dressing to seal the wound. It also helps aid in clotting.
- Elevate the injury except if the wound is within the chest or abdomen area (waist and up).
- Use tourniquets only if the bleeding did not stop after applying pressure and elevation.
- Monitor the level of response. Stay with the victim until emergency services arrive.
First Aid for Hanging or Suffocation
Asphyxiation or the process of oxygen deprivation resulting in unconsciousness or death can be done by several methods. The use of a plastic bag or suicide bag is a common method for suffocation.
Asphyxiation is also present in hanging and strangling. Both can obstruct the blood flow to the brain as well as block airflow from the lungs.
What to Do in the Case of Hanging or Suffocation
- Make sure the scene is safe from any danger. Remove the thing that causes constriction from around the victim’s neck. Provide support to the body if it is still hanging.
- Call or have someone else call the emergency services.
- Lay the victim flat on their back or the floor. If you suspect a spinal injury, do not move the person unnecessarily.
- Check for breathing and pulse. If the person is not breathing or showing any signs of life, begin CPR.
- If the person is conscious, place them in a recovery position and monitor until emergency responders arrive.
In hanging cases, try not to interfere or destroy any material such as a knotted rope. These may be needed as evidence for police work.
First Aid for Overdose or Poisoning
Swallowing, inhaling, touching, or injecting various chemicals, drugs, gases, or venoms can cause poisoning. Both suicide and unintentional drug overdose kill adults at twice the rate today as they did many years ago. Opioids or narcotics are key contributors to this rise.
When a drug overdose occurs, you may not exactly know what kind of drug the person has taken. Often, an overdose victim will either be unconscious or semi-conscious. Because of this, it is critical to recognise general signs of a drug overdose. It is also important to know what to do for first aid in the majority of situations.
What to do in a Drug Overdose Emergency
- Ensure scene safety and check for the person’s alertness.
- If the person is conscious, provide them assurance and comfort.
- If they are unconscious, turn them on their side to prevent asphyxiation or choking on their vomit.
- Call emergency medical services even if the person seems not to be experiencing overdose symptoms. Do not wait to see if the overdose will wear off. Some overdose effects do not present themselves right away.
- Check for breathing and pulse. If the person is not breathing normally, start CPR.
- Remove unnecessary clothing if needed. Some drugs can cause the patient to overheat quickly.
- Try to find the details to help with its first aid treatment. Find out what drug the victim took, what amount, when, and by what method. If the victim is unconscious, look for surrounding containers, needles, syringes, and other items.
First Aid for Self-Harm or Self-Cutting
Cutting, skin carving, or burning oneself to induce pain are examples of self-harming behavior. Self-inflicted injuries can indicate several different things. Many people who practice self-injury do not intend to kill themselves. They may even see it as a way of avoiding suicide. It is important to note that the pattern of self-injury may occur over weeks, months, or years.
Here is what you should do if a self-harm situation presents to you:
- Make sure that the scene is safe. Assess both the situation and the casualty. Check for responsiveness. Call or have someone else call emergency services.
- Locate and control the bleeding. Notice that arterial blood is bright red in colour, and it spurts or sprays from the wound. If the blood is darker in color and easy to manage, it only means that the veins are cut.
- Apply direct, firm pressure on the bleeding wound. Use a towel or dressing directly to the wound.
- Elevate the area of injury. Position the limb so that it is above the victim’s heart.
- Pinch an artery just above the injury. If possible, apply pressure to the artery to stop the blood flow to that limb. If the bleeding does not stop after direct pressure, the next option is to use a tourniquet.
Assuming that you successfully stop the bleeding, continue to assess the victim. Check for circulation, airway, and breathing. Follow the Basic Life Support or the BLS algorithm.
Suicide is a complex situation best handled by professionals. But like suicide-related physical emergencies, knowing mental health first aid can help. Use these tips from the Mental Health First Aid curriculum when handling suicide emergencies.
1. Look for signs and symptoms
Whether you are considering suicide or know someone who is, learn the warning signs and know how to help. You may save your own life or someone else’s.
While others may exhibit multiple signs, others won’t show any. It is important to know the subtle suicide signs and be on alert when talking to those around you.
2. Ask them directly
If you suspect someone might be at risk of suicide, it is important to ask them directly. Do not go beating around the bush – ask them: “Are you having thoughts of suicide?” or “Are you thinking about killing yourself?”
3. Listen nonjudgmentally
The last thing that the person who is having suicidal thoughts needs is unnecessary opinions and judgments. If you think that the person needs someone to talk to, you can engage them in conversation. Ask how they are feeling and how long they have been feeling this way. Listen in a kind, respectful way so that the person feels comfortable to talk openly without judgment.
4. Let the person know you are concerned and willing to help
Offer the person kindness and attention as they need that the most. Let them know you are willing to help and find the support they need. Provide the resources for professional help, such as through a therapist, physician, friend, or family member. If you are having concerns for the person’s immediate safety, call emergency services.
Remember, these steps do not necessarily have to go in order. Apply them in whichever way that will help you and the person you are addressing.
To learn more support strategies, take a first aid training course. It will teach how to identify, understand, and respond to signs of suicide.