MDCalc

ED-SAFE Patient Safety Screener 3 (PSS-3)

Screens for suicidality in emergency patients.

Use as an initial quick screen for suicide risk.

Ask the patient:

Over the past two weeks, have you felt down, depressed, or hopeless?
Over the past two weeks, have you had thoughts of killing yourself?
In your lifetime, have you ever attempted to kill yourself?

Result:

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Advice

Patients screening positive should be further assessed by the treating physician to determine if a mental health professional should be consulted. A safety plan may also be considered.

Management

  • The ED-SAFE PSS-3 is a screen and not an endpoint. A positive screen should prompt provider to delve deeper in assessing the patient for suicidality and to consider consulting a mental health professional for the patient.

  • More in-depth screens or assessments for suicide risk include the Beck Scale for Suicide Ideation (BSSI) and Columbia Suicide Rating Scale (C-SSRS).

  • Patients for whom providers have high concern for suicidality should be assessed by a mental health specialist.

Critical Actions

The ED-SAFE PSS-3 is meant to be a universal screening tool. Patients presenting to the ED, regardless of whether the primary complaint is psychiatric or not, can be screened with this universal screening tool.

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