Hanging on in quiet desperation is the safety way

Thought I’d something more to say…

Beware the alligator roll: One quick item for your consideration (I’ve been “sitting” on this one for a little bit). When one considers ligature risks in the environment (as with all risks), one of the evergreen truisms is that risks are very often in the eye of the beholder. So, the question then becomes at what height does a ligature point become a risk that transcends what might be considered a minimal risk. There is certainly information from various sources that self-harm (mostly asphyxiation) can occur at any height—individuals have fixed a ligature to a low pipe and around their neck and then spun their body to twist the ligature until they were asphyxiated, often described as an “alligator roll” or “crocodile roll” (depending on your reptilian preferences). Our friends in Chicago recently updated one of their FAQs on the subject to reinforce consideration of the potential for at-risk patients to harm themselves. If there’s one thing I’ve learned over the years, it’s that persons wishing to harm themselves are often quite creative in how they make use of elements in the physical environment. That said, as creative as folks might be, they usually are not able to “create” while someone is watching; for example, I’m not aware of anyone using the alligator roll to harm themselves while someone was watching them. To me, this pinpoints the criticality of the assessment process and ensuring that folks who are at serious risk for self-harm are put under observation. There is no such thing as a completely risk-free environment and we need to make sure that the assessment process takes into account that “reality.”

As a closing thought for this Thanksgiving week, while the fall is probably my favorite time of year, there always seems to be a component of melancholy to experience (i.e., endure), usually in the form of reflection. There’s also the element of missing folks near and dear who are no longer with us in the corporeal sense (I rely a great deal on the memories of the dearly departed), but I try to remember to be thankful for all that has come before, as well as what we have now. It’s hard not to think of it all as a continuum, but that may just be me. So, as we close in on the end of Year 2 of the Time of COVID, I want to thank each and every one of you for your support and interest in the safety profession as well as this little slice of whatever it is. I appreciate everything you folks do, day in and day out, and my hope is for us all to get through this together. A most joyous and restful Thanksgiving to you and your families—enjoy the spirit of community to the extent that you can!

About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at stevemacsafetyspace@gmail.com.