A revised and refined version of the O'Carroll et al. (1996) nomenclature for suicidology is presented, with a focus on suicide-related ideations, communications, and behaviors. The hope is that this refinement will result in the development of operational definitions and field testing of this nomenclature in clinical and research settings. This revision would not have been possible without the international collaboration and dialogue addressing the nomenclature of suicidology since the O'Carroll et al. nomenclature appeared in 1996.Although it is doubtful that we will ever be able to construct universally unambiguous criteria to comprehensively characterize suicidal behaviors (and, overall, firmly establish the intention behind them), for scientific clarity it would be highly desirable that the set of definitions and the associated terminology be explicit and generalizable.

Since the publication of the O' Carroll et al. (1996) nomenclature for suicidology, there have been a number of published letters and articles, as well as an active e-mail dialogue, in response to, and elaborating upon, this effort to establish a standard nomenclature for suicidology. This new nomenclature has been presented on a number of occasions at both national and international meetings. In this paper we provide the background, rationale, and methodology involved in the process of revising the O'Carroll et al. nomenclature, based on the feedback and discussions that have ensued over the past 10 years.Those who have written and studied the phenomenon of suicide have not defined the term so simply . . . how the word is defined has implications and large effects for statistics that are compiled on the official number of suicides, and for researchers, so that there is clear communication regarding what and who is being studied.Among writers in the field of suicidology there is no single common accepted definition . . . the term suicide refers not to a single action but more broadly to a great many varied behaviors. For example, one can speak of suicidal thoughts, intentions, ideation, gestures, attempts, completions, equivalents.Thus far, no single term, definition, or taxonomy has served to sufficiently represent the complex set of behaviors that have been suggested as suicidal. A Morton

This report describes the development of an evidence-based guideline for external hemorrhage control in the prehospital setting. This project included a systematic review of the literature regarding the use of tourniquets and hemostatic agents for management of life-threatening extremity and junctional hemorrhage. Using the GRADE methodology to define the key clinical questions, an expert panel then reviewed the results of the literature review, established the quality of the evidence and made recommendations for EMS care. A clinical care guideline is proposed for adoption by EMS systems. Key words: tourniquet; hemostatic agents; external hemorrhage.

The rural preventable death rate from trauma is not dissimilar to that found in urban areas before the implementation of a trauma care system. Inappropriate care rendered in the emergency department related to airway and chest injury management occurs at a high rate. This seems to be the major contributor to preventable trauma deaths in rural locations. Education of emergency department primary care providers in basic principles of stabilization and initial treatment may be the most cost-effective method of reducing preventable deaths in the rural setting.