Is the self-cutting the problem? Probably not, so any way of treating
the wounds is probably OK. Except that as EM docs. we have to
understand potential wound and injury problems as well as being very
amateur psychiatrists. So we have to look for the nerve tendon etc
injuries because of the litigation involved if we don't. Then treat the
patient as if the wound was nothing more than a flea bite and address
the real problem.
In a major teaching unit not a million miles from me the local self-harm
group is mainly the patients, who are telling the medical establishment
what treatment and attitude they expect when they present. Why does
everyone want to be heard in A&E at the end of the shift? Is this
really emergency medicine? Surely the psychiatrists can put on a
bandage or is that too much to hope for?
--
Charles Scott
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