Domestic Violence and Nonfatal Strangulation Assessment. Patricia M. Speck, DNSc, ARNP, APN, FNP-BC, DF-IAFN, FAAFS, DF-AFN, FAAN

of a respiratory passage by constriction of the neck, obstruction in the trachea, or swelling of the larynx.

      —Hanging: Suspension from a cord or cord-like object wound around the neck.

      —Jugular vein: Veins transporting deoxygenated blood from the brain back to the heart.

      —Lethality of strangulation: Odds of death as a result of strangulation.

      —Ligature strangulation: Strangulation without suspension using a cord-like object.

      —Manual strangulation: Strangulation using the hands, fingers, or other extremities.

      —Petechial hemorrhage: Subcutaneous hemorrhages presenting as small purple or red spots on the skin. Characteristic of asphyxia by external force.

      —Strangulation: Asphyxia characterized by closure of the air passage or vessels of the neck as a result of external pressure.

      —Suffocation: External prevention of respiration via occlusion of nose and mouth with an object.

       INTRODUCTION

      The following cases represent a compilation of many different patients and are not intended to represent an individual case. Any similarity is purely coincidental. The photographs are from individual cases, but the patient’s faces have been obscured for the purposes of this publication.

      The Domestic Violence and Nonfatal Strangulation Assessment assists first responders, nurses and physicians, nurse practitioners, physician assistants, emergency room health care providers, attorneys, and law enforcement personnel in the assessment and documentation of strangulation cases.

      First responders and health care providers evaluating patients who have been strangled often face challenges related to lack of education, knowledge, experience, and competence. The reasons include limited contact with this particular patient population, lack of access to experts who provide ongoing evaluation and peer review, and increasing demands from employers to manage all patients effectually. To maintain and improve highly specialized skills necessary for the evaluation of patients who have been strangled, this workbook improves provider’s understanding about the assessment, documentation, and treatment of strangulation, thereby improving competency and allowing for improved quality of care for strangulation patients.