An Epidemiology of Pediatric Suicide Attempts
Introduction: Suicide is the second-leading cause of death for individuals between the ages of 10–24, and it is estimated that 2 million adolescents attempt suicide each year. While there is literature describing epidemiological factors associated with pediatric suicidality, little is known about the presentation of this population in a prehospital setting.
Objective: To describe epidemiological and patient-related factors of a nationwide population of prehospital pediatric suicide attempts.
Methods: This was a retrospective epidemiological study performed using nationwide data from ESO Solutions from January 1, 2017–December 31, 2017. The database contains prehospital patient care records for over five million EMS responses from more than 900 agencies across the U.S. and encompasses a broad range of practice settings from urban to rural. All patients who had an EMS provider primary impression of suicide attempt were included, and descriptive statistics were utilized to describe the sample. A licensed professional counselor associate (LPCA) categorized chief complaints into 26 subgroupings.
Results: A total of 2,698 patients met inclusionary criteria, of whom 65.2% (n=1,759) were female and 26% (n=702) were minorities. Suicide attempts accounted for approximately 1% of the overall sample from the data set. Mean age was 15.5 ± .05 years with a range of 6–18. Patients identified as prepubescent (<13 years) accounted for 15.3% (n=413) of the sample. Average EMS response time was 11.75 ±33.36 minutes, and 457 (16.9%) attempts had a traumatic component. Suicidal ideations without actual attempt were the highest subgrouping (n=990; 36.7%), followed by nonspecific suicide attempt (n=414; 15.3%), overdose (n=390; 14.5%), lacerations (n=172; 6.4%), and depressive symptoms (n=101; 3.75%). Upon EMS arrival, 5 patients were observed to be in cardiac arrest. Of these, resuscitation was attempted on 2, and 1 achieved ROSC. Twelve patients were intubated.
Conclusions: Pediatric suicide is a significant cause of premature death, especially among adolescents. Our study shows the prepubescent population is at risk. EMS data does not accurately describe the methods used to attempt or complete suicide and more research is needed to further define suicidality in EMS pediatric patient cohorts.