| Risk Factors
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.
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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 depend on the cause of the strangulation.
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:
- Mental changes such as memory problems, depression, insomnia, and anxiety
- Loss of consciousness
- Weakness or numbness
Damage to the structures of the neck such as hyoid bone, voice box, or windpipe can cause:
- Difficulty breathing
- Difficulty swallowing
- Difficulty speaking
Some visible damage may include:
- Broken blood vessels in the eyes or on the skin
Repeated strangulation can increase the risk of long-term damage and death.
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 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
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.
Choking game prevention, children ages 6-19 years. Centers for Disease Control and Prevention website. Available at: http://www.health.ny.gov/prevention/injury_prevention/children/fact_sheets/6-19_years/choking_game_prevention_6-19_years.htm. Accessed November 6, 2015.
Household safety. Nemours Kid's Health website. Available at: http://kidshealth.org/parent/firstaid_safe/home/safety_entrap.html#a_Avoiding_Potential_Hazards. 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.
Last reviewed November 2015 by Michael Woods, MD
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