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Deliberate self-harm (Clinical
presentation (FB insertion
Sharp/harmful…
Deliberate self-harm
Clinical
presentation
FB insertion
Sharp/harmful into cavities, orifices, direct to flesh
Cutting/stabbing
Wrists, legs, abdomen
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Burns
Cigarettes, hot water, chemicals
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Risk factors
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Psychological factors
Substance misuse e.g. alcohol, drugs
Depression, BPD, PD
Social factors
Relationship breakdown, abuse/neglect,
financial/housing problems, poor support
Diagnosis
Examination
Derm
Old scars, bruises, scratches
Cardio
HR, BP, arrhythmias
Resp
RR, sats, erratic breathing
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Investigations
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Bloods
FBC, CRP, U+E, LFTs,
clotting, group&save
Toxicology screen
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History
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PC/HPC
Aim of the act (death?)
What prompted the act
Impulsive or planned (left note?)
How found and arrived A+E
Regret?
SH
Alcohol and drugs
Employment/finances
Social support, relationships,
criminal activity
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Management
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Definitive
Treat physical injury
Cuts, poisoning etc.
Senior help, TOXBASE
Psychiatric assessment
RAID referral to assess needs
May need crisis team, community MH team, GP follow up
May need psych admission under the Mental Health Act
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Pathophysiology
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Expression of distress, relief of tension
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Definition
Intentional self poisoning or injury
irrespective of purpose of the act,
as an expression of emotional distress