Consider what the patient thinks a suicide attempt would accomplish
(for example, death or revenge). Patients with a precise plan, lethal method (guns, knives, jumping, drowning, drug overdose, carbon monoxide), and poor chance of
rescue (using a gun provides a poor chance of rescue; taking pills in the presence of others provides a good chance of rescue) need immediate safety and suicide precautions in the ED or hospital. Document your observations, notify the attending
healthcare provider, and recommend a psychiatric consult. In a community setting, refer the patient to urgent or emergency care.