• Strangulation

    Definition

    Strangulation is squeezing of the neck with enough force to block the flow of blood to the brain and/or the flow air to the lungs. The loss of blood flow deprives the brain cells of vital oxygen. Even short periods of time without oxygen can cause damage to the brain.
    The Brain
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    Causes

    Strangulation may be caused by someone’s hands or arm, or an item wrapped around the neck. It may be the result of:
    • An act of violence
    • An accident
    • Participation in activities with intentional strangulation

    Risk Factors

    Risk factors depend on the cause of the strangulation.

    Symptoms

    Symptoms will depend on the force that is applied and the length of time it is applied. Some symptoms will be immediate while others may take a few hours or days to appear.
    The interference with blood flow can cause:
    • Confusion
    • Mental changes such as memory problems, depression, insomnia, and anxiety
    • Lightheadedness
    • Loss of consciousness
    • Weakness or numbness
    • Death
    Damage to the structures of the neck such as hyoid bone, voice box, or windpipe can cause:
    • Difficulty breathing
    • Difficulty swallowing
    • Difficulty speaking
    • Pain
    Some visible damage may include:
    • Redness
    • Bruising
    • Scrapes
    • Swelling
    • Broken blood vessels in the eyes or on the skin
    Repeated strangulation can increase the risk of long-term damage and death.

    Diagnosis

    The diagnosis is made based on information provided by the patient or a witness, and a physical exam.
    Blood tests and x-rays may be done to look for any damage

    Treatment

    Treatment will be based on the severity of injury.
    • Soft tissue injuries can be managed with ice and rest.
    • Soft foods or a liquid diet may be recommended if swallowing is too painful or difficult.
    • Over the counter pain relievers may be advised to help reduce discomfort and swelling.
    More severe injuries may require medical or surgical support to:
    • Treat pain
    • Support breathing until the throat heals
    • Address mental changes due to brain damage
    • Repair any injuries
    • Learn new swallowing techniques
    Referral for counselling may be needed

    Prevention

    To help reduce your chance of strangulation:
    • Seek help if you are in an abusive relationship.
    • Avoid harmful behaviors that may block blood flow to the brain or air flow to the lungs. Even minor interruption in blood flow can cause damage to the brain.

    RESOURCES

    Centers for Disease Control and Prevention http://www.cdc.gov

    Nemours Kid's Health http://www.kidshealth.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Parachute http://www.parachutecanada.org

    References

    Choking game prevention, children ages 6-19 years. Centers for Disease Control and Prevention website. Available at: http://www.health.ny.gov/prevention/injury%5Fprevention/children/fact%5Fsheets/6-19%5Fyears/choking%5Fgame%5Fprevention%5F6-19%5Fyears.htm. Accessed November 6, 2015.

    Household safety. Nemours Kid's Health website. Available at: http://kidshealth.org/parent/firstaid%5Fsafe/home/safety%5Fentrap.html#a%5FAvoiding%5FPotential%5FHazards. Updated August 2013. Accessed November 6, 2015.

    Strangulation injury—emergency management. DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T902787/Strangulation-injury-emergency-management. Accessed November 6, 2015.

    Strangulation signs and symptoms. Center for Relationship Abuse Awareness website. Available at: http://stoprelationshipabuse.org/pdfs/Strangulation.pdf. Accessed November 6, 2015.

    Revision Information

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