Prior to ten years ago, few health care and legal professionals had little awareness of the presence and seriousness of strangulation as a form of domestic violence assault. Indeed, the first hint that manual strangulation injuries might be more common than realized appeared in the medical literature in 1985.

In 2001, a landmark series of six articles addressing strangulation as a form of domestic violence assault appeared in the October issue of the Journal of Emergency Medicine. Since then, much has happened as more and more legal and health professionals have been trained in how to recognize and document strangulation assault and in how to care for victims of strangulation.

We now know:

• Manual strangulation accounts for 97% of all domestic violence strangulation attacks 
• Of women who present to a busy emergency department for treatment of a domestic violence physical assault, 23% of them have been strangled
• 50% of women who are examined within a few hours of being strangled have no signs of strangulation injury
• Strangulation assault is a life-threatening event that takes a major toll on the lives of many of the survivors of the attack
• Women who have been strangled within the past 24 hours should be admitted or observed in the hospital

This issue of the Health After Trauma eZine is dedicated to the topic of strangulation as a form of DV/IPV assault.

 

In 1995, two teenagers died as a result of domestic violence: Casondra Steward (17) and Tamara Smith (16). Both teenagers were also young mothers. Both had a history of domestic violence and had previously been choked before their deaths. The deaths of these two teenagers were shocking and a sobering reminder of the reality of teen relationship violence. The abrupt deaths also led to an informal death review, a study of existing strangulation cases being prosecuted within the San Diego City Attorney's Office and specialized training for domestic violence professionals.

Fourteen years later, our effort to not let Casondra and Tamara die in vain has grown stronger. Working with professionals from around the country, 26 states have passed felony strangulation statutes. Minnesota even studied the impact of its new law. There are numerous published articles, training videos, sample questions for experts to use in court, brochures for police officers, specialized forms, journals for victims to log their signs and symptoms, improved advocacy and safety planning, and much more.

Through education and awareness, we have gone from calling it a "choking" or "just a misdemeanor" to recognizing in most domestic violence situations we are dealing with a serious, felonious strangulation case. We recognize now that strangulation is serious and one of the most lethal forms of domestic violence: unconsciousness may occur within seconds and death within minutes. Victims may have no visible injuries whatsoever. Yet because of underlying brain damage by lack of oxygen during the strangling, victims may have serious internal injuries or die days or several weeks later. Strangulation may also cause victims to have ...

 

Many states have now deemed a strangulation assault to be a felony. However, jury members often do not understand the seriousness of strangulation. A medical expert witness will help explain strangulation as serious assault

If you are a health care provider preparing to serve as an expert witness for a strangulation case or a prosecutor preparing for trial, these "Questions for Strangulation Experts" developed by Dr. George McClane, Dr. Dean Hawley, and attorney Gael Strack will be a very useful tool for you.

 

Strangulation or "choking" has recently become known as a form of interpersonal violence causing serious injury. Patients presenting with no external evidence of trauma can have life-threatening internal injuries as a result of blunt force injury to neck tissues. Recent research describes this form of violence as serious and worthy of higher consideration from health care and legal professionals. Some states have passed laws making nonfatal strangulation a felony offense.

It is important to distinguish...

 

I feel extremely fortunate and very grateful to be alive after years of abuse. Over a thirty-year span of time, I've had a unique opportunity as a survivor and as a nurse to take part in the growth process as we care for victims of violence. I've learned to embrace the fact that as we continue moving forward, we must never forget where we've been.

Thirty years ago, the overall response to domestic violence and sexual assault was less than favorable. Advocacy was in its infancy. Victims were often questioned as if they had caused the violence. Domestic violence was considered ...

 Are You Looking for a Speaker?

Finding a speaker for your upcoming events can be a daunting task. Solutions to finding the just-right speaker range from word of mouth to using professional bureaus. If you are looking for a speaker or have a last-minute cancellation in your upcoming event, contact DrT for help. Let her know about your needs, location, etc., by clicking here.

Do you need an expert witness?

If so, contact Dr.T and she will help you find one. Note that the authors of each of the articles found in this eZine can also help you and their contact information is in the articles they contributed.

• Strangulation Overview Slides from Diana Emerson, RN, NP, of the Keller Center San Mateo Medical Center 
• Go to slideshare.com and search for "Strangulation" 
• Article on the Impact of Minnesota Strangulation Law 
• Find multiple articles on strangulation on the Blue Sheepdog website
• Upcoming seminars for strangulation and domestic violence training 

 
Thyrotoxicosis crisis (thyroid storm) occurs when increased circulating thyroid hormones provoke life-threatening dysfunction of multiple organs. This life-threatening condition has now been reported to occur after a strangulation event in a 37 year-old woman.

Authors Jesús I. Ramírez, MD; Patrizio Petrone, MD; Eric J. Kuncir, MD, FACS; Juan A. Asensio, MD, FACS reported such a case in a 2004 issue of the Southern Medical Journal.

To get the article online, click below and then register as a new user of the journal's website

9th Annual Justice and Hope Domestic Violence Conference

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Best friends are where you find them.

Warning: This little video will put a small smile in your heart. If you are trying to work up a good mad about something, best to watch later.

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