In order to inform the development of a specialist 'suicide prevention nurse' to work in an Accident and Emergency department (A&E), a review of literature in the area was undertaken. Priority was given to papers describing well specified interventions with a carefully defined client group. Only eight such studies were identified and, although they do have clear implications for practice, they provide inadequate information regarding the targeting of all clients at risk of suicide. The review was therefore broadened to include all UK literature on suicide and parasuicide at population and individual levels. Three distinct groups of A&E attendees at particular risk of suicide were identified: patients attending A&E following deliberate self-harm; attendees with specific physical problems, and attendees with a known history of mental health problems. The needs of each of these groups are described, with their implications for the role of a 'suicide prevention nurse' in A&E. In conclusion, action to reduce suicide needs to be taken at all levels of the organization and the role of the suicide prevention nurse needs to include support, training and development as well as specific time limited therapy with a highly targeted group of patients at specific risk.