Why do I need to know about strangulation?

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Why do I need to know about strangulation?

If you have experienced strangulation, choking, or restriction of breathing, it is very important that you know more about what has happened to you and the consequences of this.  You are not alone about strangulation, many women report that this has happened to them and we take it very seriously. 
The impact and injuries caused by strangulation (DOC)
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What happens when someone is strangled?

Strangulation 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 very serious assault, but it may be an attempted homicide. 
Strangulation is an ultimate form of power and control, it prevents a victim from breathing, in fact a perpetrator who uses strangulation will have absolute control over their victim’s next breath.  Many people do not know that strangulation can have devastating psychological effects, or a potentially fatal outcome.
If a victim of strangulation is sober or conscious when it occurs, then most report feeling terrified and severe pain.  If strangulation persists, then unconsciousness may well have follow.  Most victims of strangulation report that, before they have lapsed into unconsciousness, they have tried to resist violently, often producing injuries on their own neck in an effort to fight off the perpetrator, and frequently also producing injuries on the face or hands of their perpetrator.  These injuries are called defensive injuries.  Defensive injuries may not be present if a victim is physically or chemically restrained (by drugs or alcohol) 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 deoxygenated blood from exiting the brain); and,
• Closing off the airway, making breathing impossible.  

                                                                                               
It takes very little pressure on both the carotid arteries and/or veins to cause unconsciousness.  In fact unconsciousness can occur in ten seconds.  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.
It can be frightening to know these facts, but knowledge means that you can take action to keep yourself safe and ensure that any health effects of strangulation are minimized or avoided. 

Symptoms and consequences of strangulation

Strangulation may cause the following symptoms and/or consequences: 

• Difficulty breathing;
• Raspy voice;
• Hoarseness or loss of voice;
• Coughing;
• Difficulty swallowing;
• Drooling;
• Nausea and/or vomiting; 
• Changes in behavior;
• Hallucinations;
• Headaches;
• Light headedness;
• 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. Seeking medical help after strangulation is vital, as is telling the person who examines you exactly what has happened to you and about any symptoms.

What kind of injuries may I have?

If you have been a victim of strangulation it is really important that you don't minimize it and you should look for injuries.  You may have injuries on your: face, eyes, ears, nose, mouth, chin, neck, head, scalp, chest and shoulders, including: redness, scratches or abrasions, fingernail impressions in your 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.  It is important that you look for these injuries in the first place and then monitor any changes in these signs over time.  This can enable both you and medical professionals treating you to determine the nature and scope of any internal damage that has occurred as a result of the assault.  Importantly if you have reported the assault that you have experienced then these observations can help others to understand exactly what has happened to you and may well support your version of events and lend credibility to any witness accounts of the force and duration of the assault.  It is also important that you document by ensuring that photographs are taken sequentially for a period of days after the assault as this can be very helpful in establishing a journal of physical evidence.  Ask the police, a medical professional or your advocate to take photographs of your injuries. 
You must also always also seek medical attention if you have experienced any difficulty breathing, speaking, swallowing or experience nausea, vomiting, light headedness, headache, involuntary urination and/or defecation.
Although you may feel that you have no visible injuries whatsoever, and feel fully recovered from being strangled, you should seek immediate medical attention, especially if you pregnant.  Sometimes it is hard to know what has happened to you internally as a result of being strangle, and seeking medical help may be crucial in detecting internal injuries and saving a life.