Adolescents’ Self-Inflicted Injuries Requiring ED Visits

A study on adolescents’ self-inflicted injuries reported in the July 2015 issue ofPediatrics has many findings relevant to those treating adolescents. Introductory statistics in the article included the following:

• Suicide is one of the leading causes of death for adolescents

• Self-harm, while rare below the age of 12, increases rapidly during adolescence, particularly in females

• Adolescents who are seen in the emergency department (ED) for self-inflicted injury are at a very high risk for subsequent suicide attempt, and the greatest risk period is immediately following that act of self-injury

• Between 1993 and 2008, the average annual number of ED visits for self-inflicted injury and suicide attempts more than doubled, and the most common age group was 15 to 19 year olds

The study reported on data from the National Trauma Data Bank (NTDB) for 2009 – 2012. Among the findings were:

• The percentage of ED visits for self-inflicted injures increased significantly, from 1.1% in 2009 to 1.6% in 2012

• The most common method of injury for each year was cut/pierce, followed by firearm injury

• The least common method was poisoning; however, it was noted than an injury by ingestion is not coded as trauma by the NTDB, so would not be included in the studied data set

• Although there was an increase in the number of self-inflicted injuries, there was a significant decrease in firearm injuries – 21.8% in 2012 versus 27.3% in 2009

• Females were more likely to present to the ED with cut/pierce injuries and males were more likely to be seen for injuries from firearms

• Early and late adolescents were most likely to present with cut/pierce injuries, but early adolescents were much more likely than older adolescents to utilize suffocation

• “Adolescents visiting the ED with an SII [self-inflicted injury] had a higher risk of death than adolescents visiting for other injuries.”

Donna Vanderpool, MBA, JD – Vice President As Vice President of Risk Management, Ms. Vanderpool is responsible for the development and implementation of PRMS’s risk management services for The Psychiatrists’ Program. Ms. Vanderpool has developed expertise in the areas of HIPAA and forensic practice, and has consulted, written and spoken nationally on these and other healthcare law and risk management topics. She most recently wrote a chapter concerning the risks of harm to forensic experts for Robert L. Sadoff, MD’s book Ethical Issues in Forensic Psychiatry: Minimizing Harm, (Feb. 2011/Wiley). Ms. Vanderpool received her undergraduate degree from James Madison University, and her MBA and JD from George Mason University. Prior to joining PRMS in 2000, Ms. Vanderpool practiced criminal defense law, taught business and legal courses as an adjunct faculty member at a community college and spent eight years managing a general surgical practice in Virginia.

This blog has also been cross-posted on LinkedIn.

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