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Suicidal ideation with intoxication — RCPSC EM MCQ

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HardPsychiatric emergenciesSuicidal ideation with intoxicationRCPSC EM

A patient brought for explicit suicidal intent is intoxicated, intermittently drowsy and unable to explain the consequences of leaving. Vitals and glucose are normal. What is the appropriate disposition?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Maintain a protective hold and reassess when the patient can participate

Explanation lettering: C = shown as A · D = shown as B · E = shown as C · B = shown as D · A = shown as E

D is correct because impaired mentation and inability to understand consequences preclude a reliable capacity and suicide assessment. E assumes capacity. A produces an unreliable definitive evaluation. B transfers clinical responsibility to custody. C replaces a functional assessment with an arbitrary laboratory threshold.

Reference: Emergency Care BC, Suicide Risk Assessment: https://emergencycarebc.ca/clinical_resource/clinical-summary/suicide-risk-assessment/