POCKET CARD South Dakota Violent Death Reporting System
LIFE STRESSORS
Relationship problems (intimate partner, family, or other)
Legal/criminal problems Physical health problems Job/financial problems School problems Eviction or loss of home Recent argument or fight Recent death of friend or family
SUICIDE CIRCUMSTANCES
History of suicidal ideation or attempts
Past/present disclosure of self-harm
Letter, note, text, or email of intent
South Dakota Violent Death Reporting System
GENERAL QUESTIONS CONTACT:
Matt Tribble 605-773-6744 Matthew.Tribble@state.sd.us
LAW ENFORCEMENT & CORONER QUESTIONS CONTACT:
Amanda Weinzetl 605-367-7436 Amanda.Weinzetl@state.sd.us
WEBSITE: doh.SD-VDRS
POCKET CARD
TYPES OF VIOLENT DEATHS
(Report of deaths including) Suicides Homicides Undetermined Intent Unintentional Firearm Legal Intervention and Terrorism
DECEDENT DEMOGRAPHICS
(captured on death certificate) Age, sex, race Military/veteran status Pregnancy status Sexual Orientation Marital or relationship status
INJURY/DEAT H INFORMATION
Injury/death date and time Location of injury Alcohol use suspected EMS on scene Victim seen in ER Location and # of wounds
MENTAL HEALTH
Current depressed mood Mental health diagnosis
(Specific current/previous treatment of mental illness) Alcohol or other substance use/problem
Oct. 2021
HOMICIDE CIRCUMSTANCES
Random violence Self-defense Drug involvement Gang involvement Hate crime or mercy killing A brawl (3+ people in a
physical fight) Suspect information (relationship
to victim, sex, race, age, etc.) Weapon information Witnesses
NOTE: SD-VDRS Pocket Card is a resource to assist with violent death investigations and is not meant to be a checklist. The information included in your report will assist with identifying prevention strategies.
FIREARM INFORMATION
Type (pistol, rifle, shotgun, etc.)
Make/model
Caliber/gauge
Firearm owner
Was the firearm stolen
Was the firearm stored loaded (locked)
POISON/OVERDOS E INFORMATION
Type of poison/drug (illicit, alcohol, prescription, etc.)
If a prescription drug Name of drug Prescribed to? # prescribed/# remaining
Naloxone administered (By whom) (How many doses)
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