Non-Fatal Strangulation: What Patients and Providers Must Know

Strangulation puts a victim’s life literally in the hands of their assailant. It’s an especially vicious crime that can cause pneumonia, miscarriage, stroke and even death.

“Think of abuse on a spectrum: name calling, put downs and punching the wall are on one end of the spectrum and homicide is on the other far end of the spectrum,” says Audrey Bergin, manager, domestic violence (DOVE) program at Northwest Hospital. “Strangulation is right next to homicide. It is one of the most severe forms of abuse and can kill. And the more often you are strangled, the more likely you are to have serious injuries.”

Despite the severity of these injuries, the impact of strangulation can be minimized, even by medical professionals and the victims themselves. “When there were no or minimal visible injuries – the majority with strangulation – the injury was not adequately assessed or treated,” Bergin told “Advance for Nurses” writer Matthew T. Patton. She realized that strangulation was frequently mislabeled as “choking,” and that this diminishment could carry over to the court room. Since then, she’s become an impassioned educator seeking to help medical treatment teams understand how to identify and care for strangulation victims, many of whom come through the Emergency Department (ED).

Along with Rosalyn Berkowitz, B.S.N., R.N., a clinical leader in the ED with a background in radiology, Bergin researched non-fatal strangulation; they brought their findings to the head of Northwest Hospital’s ED, and from there, a physician strangulation protocol was developed.

According to Patton’s article, “Wings of a DOVE,” the protocol contains appropriate questions for providers to ask patients and gives them a step-by-step physical examination guide. “Staff members look for subconjunctival hemorrhage, bruising, ligature marks, finger and handprint marks, petechiae about the face, eyes and mucous membranes, or marks from the patient’s struggle to release the perpetrator’s hold.”

To learn more about the strangulation protocol and how DOVE’s educational outreach is saving lives, read the full article here.

– Laura Bogart