Strangulation in domestic abuse has only recently been identified as one of the most lethal forms of domestic violence: unconsciousness may occur within seconds and death within minutes. When domestic violence perpetrators choke (strangle) their victims, not only is this felonious assault, but it may be an attempted homicide. Strangulation is an ultimate form of power and control, where the batterer can demonstrate control over the victim’s next breath; having devastating psychological effects or a potentially fatal outcome.
Sober and conscious victims of strangulation will first feel terror and severe pain. If strangulation persists, unconsciousness will follow. Before lapsing into unconsciousness, a strangulation victim will usually resist violently, often producing injuries of their own neck in an effort to claw off the assailant, and frequently also producing injury on the face or hands of their assailant. These defensive injuries may not be present if the victim is physically or chemically restrained before the assault. Victims may lose consciousness by any one or all of the following methods: blocking of the carotid arteries in the neck (depriving the brain of oxygen), blocking of the jugular veins (preventing de-oxygenated blood from exiting the brain), and closing off the airway, making breathing impossible.
Very little pressure on both the carotid arteries and/or veins for ten seconds is necessary to cause unconsciousness. However, if the pressure is immediately released, consciousness will be regained within ten seconds. To completely close off the trachea (windpipe), three times as much pressure (33 lbs.) is required. Brain death will occur in 4 to 5 minutes, if strangulation persists.
Be aware that strangulation may cause the following symptoms and/or consequences: difficulty breathing, raspy, hoarse or loss of voice, coughing, difficulty swallowing, drooling, nausea, vomiting, changes in behavior, hallucinations, headaches, light heaedness, dizziness, urination or defecation, miscarriage, swollen tongue or lips. These symptoms may be an early indication of an internal injury such as swelling, bleeding, fractured larynx (“voice box”) or hyoid bone, seizures, pulmonary edema (lungs filled with fluid) or death within 36 hours due to progressive internal injuries and/or complications. It is possible to survive the assault, regain consciousness, refuse medical treatment, and then die later from undiagnosed or unsuspected fatal injury.
Victims should look for injuries on their face, eyes, ears, nose, mouth, chin, neck, head, scalp, chest and shoulders, including: redness, scratches or abrasions, fingernail impressions in the skin, deep fingernail claw marks, ligature marks (“rope burns”), thumbprint-shaped bruises, blood-red eyes, pinpoint red spots called “petechiae” or blue fingernails. All of these injuries change in appearance over time after the assault. Some injuries, like redness, may persist for only a few minutes. Others, like petechiae, persist for days. Observation of the changes in these signs over time can greatly facilitate determination of the nature and scope of internal damage produced during the assault, and lend credibility to witness accounts of the force and duration of the assault. Documentation by photographs sequentially for a period of days after the assault is very helpful in establishing a journal of physical evidence.
Victims should also seek medical attention if they experience difficulty breathing, speaking, swallowing or experience nausea, vomiting, light-headedness, headache, involuntary urination and/or defecation.
Although most victims may suffer no visible injuries whatsoever and many fully recover from being strangled, all victims, especially pregnant victims, should be encouraged to seek immediate medical attention. A medical evaluation may be crucial in detecting internal injuries and saving a life.
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