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Suicidal ideation high risk — ABEM Board MCQ

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EasyPsychiatric emergenciesSuicidal ideation high riskABEM Board

A 35-year-old man arrives after telling his partner he plans to shoot himself. Triage acuity is ESI 2; BP 136/82 mm Hg, HR 96/min. He has severe depression, alcohol intoxication, and access to firearms at home. He refuses voluntary admission. Which of the following is the most appropriate disposition?

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Correct answer: A — Place on involuntary psychiatric hold with safety precautions and psychiatric evaluation

Active suicidal intent with lethal means and impaired judgment requires safety precautions and emergency psychiatric evaluation, including involuntary hold when criteria are met.

Reference: ACEP Psychiatric Patient clinical policy