Engine Company EMS: Responding to Suicides

Photo by Сардак Роман.

By Michael Morse

Responding to a call for a suicide or a possible suicide requires extreme caution. Consider the call as dangerous as a hazmat situation. Consider the following while en route:

  • The psychological condition of the suicidal person.
  • The method of the suicide or suicide attempt.
  • The emotional condition of people on scene.
  • The emotional condition of your crew.
  • Your own emotional condition.

 

Talk About It

Talking about what to expect on a call for a suicidal person helps when the real thing comes your way. Not everybody has the same empathy level.  By talking when there is no pressure, you can assess the strengths and weaknesses of your crew. The company officer may or may not be the best equipped to handle an emotionally charged survivor, just as the engineer might not know how best to assess a patient for signs of life (see: www.fireengineering.com/articles/2016/10/engine-company-ems-living-or-dead.html).

One suggestion is to designate a crewmember as primarily responsible for crew safety; this frees the other members to assess the patient, calm survivors, and notify the proper authorities without distraction. The potential for hazards at the scene of a suicide are immense. Having one person dedicated to seeing, hearing, and smelling threats cannot be understated.

Electrocution, firearms, poisoning, overdoses, toxic chemicals, and many previously inconceivable ways of ending a life are painfully effective, not only for the suicidal person but also for the responders. It is imperative to be aware of the volatile nature of a suicide response not only for your own benefit but also for the benefit of the entire crew. Communication is essential. Encourage each and every member—be it a two-, three-, four-, or more person company—to voice their concerns while responding and again following the incident. Facing mortality is an emotionally charged experience under normal circumstances; suicide makes it even more so.

 

RELATED: PTSD and Suicide in the U.S. Fire ServiceBohrer on Chemical Suicide AwarenessNorwood and Rascati on Suicide Is a Reality in the Fire Service

 

Preplanning a suicide response is not something an engine company normally thinks about, but it can be remarkably effective prior to responding to one. Going into any scene unprepared is never a good idea.  Entering the scene of a recent suicidal event profoundly affects everyone. These are the calls that haunt the most experienced among us; these are the calls that end careers. They are calls that can lead to the unthinkable: firefighter suicide.

I have found that there is not only strength in numbers but comfort in numbers as well. Going your separate ways after the call may be business as usual and, although perfectly fine in most cases, it is not as much so following something as traumatic as suicide. Some members are not bothered by what they see; others cannot stop thinking about it. The same person that shrugs off a suicide may come unglued at the sight of a burned infant. The member having nightmares about a suicide call might handle the burned infant with ease. People are different and respond differently to traumatic events.

The strength of the engine company is our cohesiveness; if one hurts, all hurt. Sometimes we forget that if something doesn’t bug us, it very well may be bugging somebody else. Again, communication is key. If everybody involved in a traumatic incident is comfortable expressing his feelings following the event because the crew took the time to discuss what might happen, the chance of post-traumatic stress disorder or acute stress reactions can be lessened.

None of us enter the firefighting profession equipped with the tools needed to navigate everything that comes our way. The things we see that would drive most sane people mad are sadly all in a day’s work. Unrealistic expectations concerning our own mental health lead to the erosion of our ability to enjoy the life we work so hard at providing for our families. It would be a shame to miss out on all that life has to offer because we thought we were different and could handle things that nobody has the right to expect us to…

…Especially ourselves. Stay safe. Stay sane. We deserve it.

 

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Michael Morse is a captain (Ret.) with the Providence (RI) Fire Department (PFD). He is also the bestselling author of Rescuing Providence, Rescue 1 Responding, City Life, and Mr. Wilson Makes it Home. Morse has been active in emergency medical services (EMS) since 1991 and offers his views on a variety of EMS and firefighting topics, focusing mainly on the interaction between patient and provider. In addition, Morse is a Johnson/Macoll fellow in literature from the Rhode Island Foundation. Follow Morse on Twitter and Facebook. He can also be reached at mmorsepfd@aol.com.

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