A 64-year-old male with a history of bipolar 1 disorder, PTSD, anxiety, depression, obsessive-compulsive disorder, GERD, and HTN presented to the ED with the chief complaint of foreign body and self-injury. He reported years of sticking sewing needles into his right arm, most recently yesterday. He explained that inserting needles makes him feel better with mild associated pain. He endorsed suicidal ideas, elaborating that he did not want to stop injuring himself. He also reported depression and wished that he was not alive. He stated that he had told his therapist that he didn’t want to present to the ED today and added that he wanted to leave the ED and did not want to be seen by the psych team. He denied homicidal ideation.
SAEM Clinical Images Series: When Needles Go Beyond Sewing and Acupuncture
2024-10-15T10:59:39-07:00
By: Winston Wu, MD, Justin Yaworsky, MD and Dylan Soderstrum, MD |Editors: Jessica Hoglund, MD; Moises Gallegos, MD, MPH