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.
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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:
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 happen right away while others take a few hours or days to appear.
The block in blood flow can cause:
Damage to the structures of the neck can cause:
Some visible damage may be:
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
The goal of treatment is to promote healing. Choices are:
Referral for counselling may also be needed. It depends on the cause.
People with severe injuries may need surgery to repair any injuries.
The risk of this problem may be lowered by:
Centers for Disease Control and Prevention
Kid's Health—Nemours Foundation
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