Self-harm and physical safety – when and how to seek further help
Any time that someone self-harms, it’s an indication that support and listening are needed. If you’re self-harming or someone you care about is, please seek the support of someone you trust such as a parent, teacher or GP (family doctor).
This information seeks to highlight when physical safety may be in danger and medical support is needed. People who self-harm often put themselves in unintended physical danger as a result of shock, infection or poisoning. Here we have provided the information needed to try to avoid this. If you see any of the signs outlined below you should seek medical treatment as soon as possible.
When to call an ambulance
- Following an overdose of drugs, alcohol or prescription medication
- Loss of consciousness or drowsiness
- Extreme pain
- Difficulty breathing
- Loss of a lot of blood from a cut or wound
- There are signs of shock following an injury
A young person who is actively experiencing thoughts of self-harm or suicide, should not be left unattended for any length of time. If you do not think you can keep a young person safe, take them to your local accident and emergency department (or follow their agreed crisis plan if one is pre-existing).
Other instances when medical attention should always be sought
- If a wound continues to bleed heavily once elevated or bandaged
- If a wound is deep and has exposed underlying muscle
- If sensation is lost either in the area of the injury, or more widespread
- If a burn is on a sensitive area of the body (e.g. face), over a joint or on the palm
- If a burn is severe, or large in area
- If a burn is caused by chemicals
- If a wound becomes infected
- If there is a loss of sensation, movement, function or strength of a limb
If you are ever in doubt, phone the NHS 111 service by dialling 111 or contact your GP, and they will give advice. NHS 111 will provide you with a trained nurse to talk to almost immediately.
Depending on their severity, these issues can usually be treated at a minor injuries unit (MIU). These healthcare services are run by doctors or nurses to assess and treat minor injuries, such as minor burns and scalds, infected wounds and broken bones.
Less severe injuries can be treated at NHS walk-in centres, where a nurse can treat you without appointment, and are also available for minor cuts and bruises.
Find your local A&E department, MIU or walk-in centre.
Signs of shock
Always seek immediate medical attention if shock is suspected. Signs include:
- Feeling very weak or shaky
- Being overcome with dizziness or light-headedness
- Feeling cold and clammy
- Very fast, shallow breathing
- Being overcome with feelings of confusion or anxiety
Signs of infection
Signs that a wound has become infected include:
- Swelling, redness and increasing pain in the affected area
- Pus forming in or around the wound
- Feeling generally unwell
- Swollen glands under the chin or in the neck, armpits or groin
- Apply pressure to reduce bleeding and raise the injury if possible to reduce blood flow and allow time for a clot to form
- If blood is pumping out from the injured area, firm direct-pressure is needed for at least 5-10 minutes and you should call an ambulance
- When bleeding is controlled, cover the wound with a clean dressing and apply direct pressure to prevent bleeding
- If direct pressure is not appropriate, such as when something is stuck in the wound, apply indirect pressure by pressing the wound together – do not remove the object, but call for an ambulance
- When burns are caused by heat, the priority is to lower the temperature of the affected area. Rinse the area under cold running water for at least 10 minutes
- Do NOT apply any creams, balms, oils, moisturisers or anything except cold running water
- If there is any clothing surrounding the burn remove this by either taking it off or cutting it away; this also applies to removing constricting objects such as rings, watches, bracelets as the area may later swell
- If there is anything that is already stuck to the burn, DO NOT remove it. Seek medical attention
- If a burn isn’t painful, this can indicate nerve damage so medical attention should be sought
- If the burn was caused by a liquid chemical wash this off with lukewarm water for at least 30 minutes
- If the chemical is dry, then brush the chemical off before rinsing the area in water
- Do not try and neutralise the chemical
- All chemical burns should be referred to a Doctor, either by attending your local Walk-in-Centre or the nearest A&E Department
Download a printable copy of this information: Self-harm and physical safety – when and how to seek further help