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Strangulation

How to Say It: Strang-u-lay-shun

Definition

Strangulation is when the neck is squeezed with enough force to block the flow of blood to the brain and the flow of air to the lungs. The loss of blood flow deprives the brain cells of oxygen. Even short periods of time without oxygen can cause damage to the brain. This can be deadly.

The Brain

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Causes

Strangulation may be caused by someone’s hands or arm. It may also be caused by an item wrapped around the neck. This may be the result of:

  • An act of violence
  • An accident, especially home hazards in young children
  • Suicide attempt
  • Participation in activities with intentional strangulation

Risk Factors

Risk factors depend on the cause of the strangulation.

Symptoms

Symptoms will depend on the force that is applied and the length of time it is applied. Some symptoms happen right away while others take a few hours or days to appear.

The block in blood flow can cause:

  • Lightheadedness
  • Weakness
  • Numbness
  • Confusion
  • Memory problems
  • Trouble sleeping
  • Loss of consciousness
  • Mental health problems

Damage to the structures of the neck can cause:

  • Problems breathing
  • Problems swallowing
  • Problems speaking
  • Pain

Some visible damage may be:

  • Redness
  • Bruising
  • Scrapes
  • Swelling
  • Broken blood vessels in the eyes or on the skin

Diagnosis

The doctor will ask about your symptoms and health history. If you cannot answer these questions, the doctor will ask a family member or someone who saw the event to do so. A physical exam will be done. This is often enough to make the diagnosis.

Blood tests and x-rays may be done to look for any damage

Treatment

The goal of treatment is to promote healing. Choices are:

  • Supportive care, such as ice and rest
  • Dietary changes, such as a liquid diet or soft foods if swallowing is painful
  • Medicines, such as over the counter pain relievers
  • Breathing support

Referral for counselling may also be needed. It depends on the cause.

People with severe injuries may need surgery to repair any injuries.

Prevention

The risk of this problem may be lowered by:

  • Keeping children away from hazards
  • Seeking help from abusive situations
  • Avoiding harmful behaviors that may block blood flow to the brain or air flow to the lungs
  • Seeking help for depression or thoughts of suicide
RESOURCES:

Centers for Disease Control and Prevention
http://www.cdc.gov

Kid's Health—Nemours Foundation
http://www.kidshealth.org

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

Parachute
http://www.parachutecanada.org

REFERENCES:

Household safety: preventing strangulation and entrapment. KidsHealth—Nemours Foundation website. Available at: http://kidshealth.org/parent/firstaid_safe/home/safety_entrap.html#a_Avoiding_Potential_Hazards. Accessed March 22, 2021.

Ibrahim AP, Knipper SH, Brausch AM, Thorne EK. Solitary Participation in the "Choking Game" in Oregon. Pediatrics. 2016 Dec;138(6).

Strangulation can leave long-lasting injuries. Domestic Shelters website. Available at: https://www.domesticshelters.org/domestic-violence-articles-information/strangulation-can-leave-long-lasting-injuries#.WjQeyFWnFEY. Accessed March 22, 2021.

Strangulation injury—emergency management. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/strangulation-injury-emergency-management. Accessed March 22, 2021.

Last reviewed December 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD  Last Updated: 3/22/2021