Strangulation/Hanging


Background

  1. Second most common form of suicide in the U.S.
  2. Strangulation
  3. Hanging (a subset of strangulation)

Pathophysiology

  1. Judicial hanging (with fall of adequate distance)
  2. Manual strangulation/ attempted suicide hangings

Diagnosis

  1. Ask about mechanism of injury
  2. Symptoms
  3. External trauma may or may not be found
  4. Need to identify injury to neck structures (i.e. airway-larynx fracture, neurovascular, cervical spine)
  5. Need to asses for laryngeal fracture
  6. Diagnostic imaging

Treatment

  1. ABCs
  2. Often need ventilatory support
  3. Tracheal intubation
  4. If comatose / altered mental status:
  5. Consult ENT for neck injuries
  6. Elevate head of bed to reduce edema
  7. Consider ICP monitoring if suspect cerebral injury
  8. Medications

Disposition

  1. Admit, ENT consult