Air Rescue Missions for Suicide: A Retrospective Analysis of a 12-Year Period From a German Rescue Helicopter Base

Objective

Typical reasons for calling the rescue helicopter are medical emergencies, such as heart disease, trauma, and neurologic emergencies. However, there are also a small number of patients with attempted or completed suicide. The aim of this article was a general analysis and evaluation of the specific circumstances of emergencies related to suicide or attempted suicide in the prehospital environment involving the rescue helicopter (helicopter emergency medical services) Christoph 38 of the DRF Stiftung Luftrettung gAG based in Dresden, Germany.

Methods

The data of all emergency interventions performed by the helicopter emergency medical services in Dresden, Germany, between January 1, 2008, and December 31, 2020, were analyzed by examining the DIVI rescue protocols and electronic data (MEDAT and HEMSDER (Convexis, Germany)) with regard to suicide-related variables. The time, methods and information about the reason, sociodemographic data, and results of medical treatment were recorded and retrospectively analyzed.

Results

There were a total of 17,754 emergencies during the study period. Of these, 277 cases (1.56%) were due to suicide. The average time for the emergency services to arrive at the scene of the emergency was 11.14 minutes. There were 52 patients with a completed suicide, 183 with a suicide attempt, and 42 patients with a suicide threat. Eleven were pronounced dead before or at the time of arrival of the emergency doctor. Of the 241 patients who were still alive when the emergency physician arrived, 101 were endotracheally intubated and mechanically ventilated, and 25 patients received cardiopulmonary resuscitation. In 19.57% of the patients, health problems were noted as the primary reason for attempted/completed suicide. In a further 12.68%, partnership problems or the loss of a partner were cited. The most common method used was an overdose (49.39%) followed by leaping from a great height (20%) and hanging (15.51%). Stab wounds and gunshot wounds were observed in 24% of the cases. The overall mortality rate was 18.77%. The method used, sex, and a suicide note were identified as possible influencing factors for the fatal outcome of a suicide.

Conclusion

The number of suicide victims is low compared with the total number of 17,754 deployments. However, the mortality rate for these missions is quite high at 18%. Although some factors and circumstances could be identified in this study, many backgrounds and explanations are still missing. Therefore, this study shows a general need for more research in regard to better prevention as well as improved education and training of emergency response teams.