Home › Mental health (patients) › Rural self-harm deaths before ambulance arrival

Mental health (patients)

Rural self-harm deaths before ambulance arrival

Factors associated with death before EMS arrival among emergency medical services-attended self-directed violence cases in southern Iran: a cross-sectional study
BMC Emergency Medicine · 2026-10-17 · Added 19 October 2026

An Iranian cross-sectional study of 2,280 EMS-attended self-directed violence cases found 5.4% died before EMS arrival, with higher odds in rural locations (aOR 2.08), older patients (aOR 1.03/year) and morning calls (aOR 2.14 vs evening).

Study type

Cross-sectional

Design

Cross-sectional analysis of EMS registry records with multivariable logistic regression

Participants

2,280 EMS-attended self-directed violence cases (124 dead on arrival)

Main finding

Death before EMS arrival associated with rural location (aOR 2.075, 95% CI 1.208–3.564), increasing age (aOR 1.028) and morning (aOR 2.140) and afternoon (aOR 1.882) calls versus evening

Caveat

Registry-only data from one Iranian province with no clinical detail on mechanism, lethality or bystander response

Bottom line

Context only

Learning goal

Recognise which patients experiencing self-directed violence face higher risk of death before ambulance arrival.

More

• Topic: Mental health (patients)
• Daily scan: 19 October 2026

Related papers on Mental health (patients)

• Building a prehospital suicidal-ideation policy from scratch

  Crisis · 10 Oct 2026 · Other · Context only

  A Los Angeles County EMS quality improvement committee developed a comprehensive prehospital policy for suicidal ideation and behaviour after identifying gaps in standardised terminology, risk assessment, disposition support and safety planning.

• Paramedics underconfident with alcohol-related call-outs

  Journal of Paramedic Practice · 30 Sep 2026 · Other · Context only

  A narrative review of paramedics' perceptions of patients who use alcohol found five themes — workload, impact, training, confidence and attitudes — with confidence dropping beyond basic conversations and attitudes often negative due to limited training and resources.

• Mapping medical clearance of psychiatric ED patients

  Annals of Emergency Medicine · 20 Aug 2026 · Systematic review · Context only

  Scoping review mapping medical screening practices for adult psychiatric patients presenting to ED — identified 8 themes (laboratory testing, history taking, vital signs, physical examination, diagnostic imaging, screening tools, ECG, system-level factors), with society recommendations discouraging routine lab testing.

• FDSV rarely detected in virtual ED

  Emergency Medicine Australasia · 4 Aug 2026 · Cohort · Hypothesis-generating

  Retrospective cohort of Victoria's Virtual ED — only 21 FDSV presentations identified among 173,936 visits (0.012%), suggesting significant under-detection