Strangulation is the act of pressure around the neck with enough force to impede respiration or circulation. Manual strangulation, with the hands, is more common than ligature strangulation using a rope or cord like object.1 True choking is an obstruction in the upper airway, although patients may describe their strangulation experience using the word choking or choked . Suffocation occurs from a lack of oxygen due to choking or smothering. Persons who have experienced intimate partner violence can be either gender, although strangulation survivors are more likely to be women.1 Studies of women living in domestic violence shelters suggest that up to three fourths of residents report strangulation as part of the violence they survived.2 In almost half of deaths involving intimate partner violence, persons have experienced at least one episode of strangulation before the fatal violent incident.3 One episode of strangulation makes the person 700 times more likely to be strangled again by the same aggressor and 800 times more likely to die at the hands of the same aggressor. 3 Only 37 states have specifically mentioned strangulation in statute, with penalties ranging from misdemeanor tofelony. 1 Health care workers, law enforcement, prosecutors, and survivors themselves are only now starting to use language illustrating the potential of death from strangulation. A survivor of strangulation has not survived an attempted strangulation; rather, this person has survived attempted murder and was strangled. Moreover, even if the patient diminishes the personal risk, the emergency nurse must be aware of symptoms associated with strangulation because many patients do not have visible external signs of injury. 1 Researchers estimate as many as 50% of persons experiencing fatal and nonfatal strangulation will have no visible externalsigns. 1 Although the emergency nurse may see bruising, scratches, redness, or petechia, the absence of visible signs is just as likely, requiring the emergency nurse to be aware of symptoms associated with strangulation and familiar with screening questions to ask the strangulation patient.
Foley, A. (2015). Strangulation: Know the symptoms, save a life. Journal of Emergency Nursing, 41(1), 89–90. https://doi.org/10.1016/j.jen.2014.10.013