Example Vignettes

    This part of the module comprises active learning, involving a series of case vignettes and guidance based on inclusion and exclusion criteria based upon the De Leo et al 2004 definition. In addition to cases of intentional self-harm, non-cases and ambiguous cases are also included.

    The points below comprise exclusion and inclusion criteria and can be used to help make decisions as to whether cases should be included or excluded.

    In all instances, these examples refer to information present in hospital records. Consequently, details may vary to reflect different levels of detail recorded in the medical records and system in place. Training to improve medical record-taking may be implemented, as necessary.

    Tip! Data collectors should familiarize themselves with common abbreviations found in medical records.

    Some examples are as follows:

    • BIBA – brought in by ambulance
    • C2H5OH – alcohol
    • GCS – Glasgow Coma Scale.

    It is also acknowledged that surveillance systems depend on the information available. In some jurisdictions, the system may be based on information from emergency room records only and no further information may be available to help decide on cases which are difficult to classify.

    Tip! If a data collector is unsure whether a case should be included or not, contact the system manager.

     

    Accidental Injury

    Exclude, if the person’s actions or behavior is the result of an accident.

    For example:

    • accidental overdose (i.e. heavy episodic drinking or intake of illicit drugs, or as an unintended consequence of dependence on alcohol or illicit drugs)
    • accidentally taking an incorrect dose of prescription medication
    • accidentally ingesting a poisonous substance
    • accidental injury related to sports or work
    • accidental injury as a result of an argumentative confrontation.

    If it is clearly the result of an accident, then the case is not intentional self-harm or suicide attempt

    Action  =  Exclude

    Vignette Example – Accidental Injury

    Admission Notes: 11-year-old boy BIBA. Injuries to head, face and chest. Mother accompanying. Says she found son at the bottom of the stairs. Explains she had asked him to sweep the house, including the stairs. Heard a noise and shouts of pain.

    Behaviour: In shock. Says he slipped. Shivering and upset.

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