Who to call in a medical emergency, such as a suicide attempt, besides 911 (Emergency Medical Services)?

Who to Call in a Medical Emergency Besides 911

Call 911 immediately for any life-threatening emergency, including suicide attempts—this is the primary and most critical action. 1 There are additional resources that can provide support, but they should not replace or delay calling 911 when someone's life is in immediate danger.

Primary Emergency Response

For any unresponsive person, active suicide attempt, or life-threatening medical emergency, 911 must be called first. 1 The American Heart Association guidelines emphasize that bystanders should immediately activate their local emergency number (911) when they find an unresponsive victim or witness a medical emergency. 1

Why 911 Should Be Your First Call

• Dispatcher guidance: Emergency dispatchers are trained to provide telephone instructions for CPR and other life-saving interventions while help is en route. 1
• Faster treatment: Patients transported by EMS have shorter time to treatment and significantly better outcomes compared to self-transport. 2
• Life-saving interventions: EMS personnel can perform critical interventions if cardiac arrest or other complications occur during transport. 2
• Reduced mortality: Approximately 1 in 300 patients with serious conditions transported by private vehicle suffer cardiac arrest en route, which EMS is equipped to manage. 2

What to Tell the 911 Dispatcher

When calling 911, be prepared to provide: 1

• Location of the incident with specific address details
• Events that occurred (what happened)
• Number and condition of victim(s)
• Type of aid already provided
• Stay on the line until the dispatcher instructs you to hang up 1

Additional Crisis Resources (Not Replacements for 911)

988 Suicide and Crisis Lifeline

For individuals experiencing suicidal thoughts but not actively attempting suicide, the 988 Suicide and Crisis Lifeline provides immediate crisis counseling. 3, 4

• When to use: For suicidal ideation, emotional distress, or mental health crises when the person is not in immediate physical danger 3
• Effectiveness: Nearly 98% of callers reported the crisis call helped them, and 88.1% said it stopped them from killing themselves 3
• Follow-up care: The Lifeline can provide ongoing support, with 79.6% of follow-up clients reporting the intervention stopped them from killing themselves 4

Critical caveat: If someone has already taken action to harm themselves (ingested pills, used a weapon, is unresponsive), call 911 first, not 988. 1

Institutional Emergency Numbers

In schools, workplaces, or healthcare facilities with their own emergency response systems, call that facility's emergency number in addition to or instead of 911, depending on the protocol. 1

• Schools should have written emergency plans with posted emergency numbers at each telephone 1
• Healthcare facilities and workplaces often have internal emergency response teams that can be activated simultaneously with 911 1

Poison Control Centers

For overdoses or ingestions (common in suicide attempts), contact information should be readily available, though 911 should still be called for any serious ingestion or if the person is symptomatic. 1

Specific Guidance for Suicide-Related Emergencies

When 911 is Mandatory

Do not discharge or leave alone any person who: 1

• Is still actively thinking of suicide
• Has made a high-lethality suicide attempt
• Is depressed, manic, hypomanic, severely anxious, or has mixed states
• Shows substance abuse alone or with a mood disorder
• Is irritable, agitated, threatening violence, delusional, or hallucinating
• Expresses persistent wish to die
• Has clearly abnormal mental state

Emergency Department Role

Emergency departments are critical intervention points, as individuals who died by suicide often sought ED care for suicide attempts in the year before their death. 5, 6

• ED visits for suicide attempts increased 47% from 1992 to 2001, making emergency departments increasingly important sites for suicide prevention 6
• Emergency room staff should establish a relationship with the suicidal individual and family and emphasize the importance of treatment 1

Common Pitfalls to Avoid

Never delay calling 911 to try other resources first when someone is in immediate danger. 1 The 988 Lifeline and other crisis resources are valuable for prevention and support, but they cannot provide the immediate medical intervention that EMS can deliver. 2

Do not rely on "no-suicide contracts" as a safety measure. 1 The value of these contracts is unknown, and the person may not be in a mental state to accept or understand the contract. Both family and clinicians should not relax vigilance just because a contract has been signed. 1

Ensure means restriction immediately: Parents must be explicitly told to remove firearms and lethal medications from the home. 1 Simply having a gun in the home doubles the risk of youth suicide, and parents often underestimate their children's ability to locate and access firearms. 1