Strangulation: Facts 2/3

I'm continuing my series on strangulation injuries. Here is Part I.

I once worked with a physician who was having a baby. Her father handmade her a crib. Sadly, his grandchild was strangled in that crib.

Vintage crib where slats are too wide.

I often think about that family-- how he must feel to have constructed the tool of this infant's demise. How was the relationship of that woman with her father after that? Definitely enough conflict in just that scenario to carry a novel.

While researching this series of posts on strangulation for a reader, I came upon a lot of interesting facts I didn't know myself. This is one reason why I'm such a research hound-- I love learning these things to add extra detail for the reader.



There are four types of strangulation:

1. Hanging
2. Manual: The use of bare hands.
3. Chokehold: Elbow bend compression
4. Ligature

Strangulation injury is not as uncommon as I thought-- it accounts for 10% of all violent deaths in the US. Perhaps because the hands are such a ready weapon-- the criminal doesn't have to think about bringing them to the crime scene.

Infants are likely to be strangled by falling between something (like slats in a crib that are too wide), or entangling themselves in something (like cords that dangle down from blinds).

Teens and pre-teens can suffer strangulation injury by playing the "choking" game or engaging in autoerotic hanging. These are not so uncommon activities in the pediatric population and we should discuss their danger with our children.

Women are increasingly using hanging as a means of suicide whereas in the past it was more common among men.

Prisoners will often kill themselves by hanging as it is the means of suicide that is most available to them.

When treating the victim of a hanging-- it is important to know the height they dropped from. A height equal to or greater than their height brings forth large concerns for C-spine injury. When a prisoner is hanged, they essentially die from decapitation. The C-spine is fractured between C1-C2 and thus severs the spinal cord(also called a Hangman's Fracture) so the head will free float. If done right, death is instantaneous.

When a person is strangled, there may be no signs of injury to the neck or very minimal signs. There may be only a single bruise present which is caused by the imprint of the thumb.

Resources:

General Overview: http://emedicine.medscape.com/article/826704-overview

Wisconsin Medical Journal: Strangulation Injuries http://www.wisconsinmedicalsociety.org/_WMS/publications/wmj/pdf/102/3/41.pdf

Emergency Medicine Reports: Strangulation Injuries. http://www.ahcmedia.com/public/samples/emr.pdf:

How to Improve Your Investigation and Prosecution of Strangulation Cases. http://www.ncdsv.org/images/strangulation_article.pdf: