Accompanying text:
This week I wanted to focus on individuals who harm themselves for one reason or another. It seems that I get dispatched out on psych runs on a regular basis.
Most of the time my patient is simply somebody who is threatening to harm themselves but on occasion I do have to deal with injuries or illnesses brought on by my patient's actions. Most people, I think, are afraid of physical pain and choose the chemical route. There are others who prefer, for whatever reason, to suffer not only emotionally but physically. It's not uncommon for them to claim that the physical pain alleviates the emotional (for a time).
I've had this collection of pictures for quite some time now. They've been floating around the internet since at least 2009. She goes by the name of Joan and is an extremely disturbed individual. She is somebody, who in my opinion, needs to be committed for long term psychiatric care.
Her lacerations are pretty serious. I wouldn't be surprised if she developed a serious systemic infection in her body.
Pre-Hospital Treatment:
I'd have PD on scene with me. Her behavior when I came into contact with her would determine whether or not we're going to have to subdue and restrain. My immediate concerns are for my own safety - Body Substance Isolation - and then for hers. Bleeding control would need to be conducted. Pressure bandages would probably do the trick but I could resort to a tourniquet if I had to. Vitals would be obtained and I'd establish IV access and begin running some fluids as well as the usual cardiac monitoring. Further treatment would be dictated by what I found in my assessment.
Basic Considerations:
Alcohol and/or drug abuse is extremely likely. Will she present with arrhythmia or other signs & symptoms? How's her breathing? What's her blood pressure? What's her pulse? Is her skin pink, warm, and dry or is it pale, cool, and clammy? What's going on neurologically? Will I have to place her in a trendelenburg position? What options did she leave me for IV placement? Etc, etc.
I'm not too concerned with the "why" because that's not really important for my purposes. There is nothing that I could say to Joan in the half hour that I would have with her that would even begin to make a difference in her mental condition.