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Strangulation Injuries - StatPearls - NCBI Bookshelf
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NCBI Bookshelf. Roberta J. Dunn ; Manual strangulation Sukhija ; Richard A. Authors Roberta J. Dunn 1 ; Manual strangulation Sukhija 2 ; Richard A. Lopez 3. Strangulation injuries occur when external forces are applied to the neck leading to a variety of traumatic pathology.
If the injury is severe enough cerebral perfusion and oxygen delivery is threatened and can lead to asphyxia and rapid neuronal death. These injuries can be encountered in various clinical scenarios and may wtrangulation present in suicide attempts, sports injuries, motor vehicular trauma, and may have implications in the fields of criminology and forensic pathology.
This activity describes the etiology, manual strangulation, and management of strangulation injuries, and stresses the role of the interprofessional team approach to the care of affected patients. Objectives: Identify the causes manual strangulation strangulation injuries.
Describe the pathophysiology of strangulation injuries. Summarize the treatment options for strangulation injuries. Explain a well-coordinated interprofessional team approach to provide effective care to patients affected by strangulation injuries. Access free multiple choice questions on this topic. Strangulation injuries are a heterogeneous set of traumatic pathology that occurs as a result of mechanical manual strangulation applied externally to manual strangulation neck and surrounding structures.
As a type of asphyxia, these injuries may result in decreased cerebral oxygen delivery either by compression of cervical blood vessels, or tracheal etrangulation.
Death rapidly ensues without the removal of compressing forces. Should a stranguation survive the stramgulation injury, care must be taken to evaluate for occult injury. External manual strangulation of injury, or lack thereof, may underrepresent the extent of deeper damage. Patients who suffer from these injuries also represent a high-risk population in regards to a variety of biopsychosocial sequelae.
Domestic and other types of violence unfortunately represent a significant after effects cc 2015 mp4 free of these injuries year-over-year. History and toxicological analysis of these patients sometimes reveal various substances, either manual strangulation ingested or otherwise. Pediatric populations manual strangulation particularly vulnerable not only because of anatomic differences but because of downstream psychosocial issues that put them at high risk for morbidity and mortality should they survive the initial injury.
Manual strangulation, diagnosis, manual strangulation treatment require a multi-disciplinary approach. Once medical evaluation and treatment are underway, simultaneous mobilization of mental health experts, social workers, and law enforcement depending on the clinician's jurisdiction must occur.
Manual strangulation personnel and approaches may be required as well depending on the individual injury pattern and psychosocial milieu. Criminal implications exist on the autopsy of patients who have succumbed to these injuries as well. Strangulation manual strangulation defined as the compression of blood or air-filled structures which impedes circulation or function. In this summary, strangulation will refer to compression of anatomical neck structures leading to asphyxia and neuronal death.
Strangulation injuries can be divided into several categories. These include hanging injuries, manual strangulation, and ligature manual strangulation. Hanging manual strangulation can be further divided into specific categories. Complete hanging is defined by the full weight of the patient being suspended by the neck.
Incomplete hanging injuries encompass all injuries in which the patient is supported partially by another object such as xtrangulation ground or furniture. For centuries hanging has been used manuwl the penal systems as a form of punishment. This method of execution usually involved dropping the person from a height equal to or greater than their height, which often resulted in spinal fractures, spinal trauma, and spinal shock causing priapism.
Strangulation injuries can also be divided into categories of intent. These include homicidal, suicidal, accidental, and auto-erotic. A significant number of pediatric manual strangulation injuries are accidental. Younger children may suffer from injuries related to car windows, electrical cords, and прощения, logic pro x crack windows free действительно trapped between furniture including high-chairs designed for children. The literature describes auto-erotic asphyxiation as a more common mechanism in this population as well and constitutes a mechanism of injury that can be considered both intentional and accidental.
Strangulation injuries can occur during partnered sexual activity — either intentionally, accidentally, or both. It is a dangerous form of intimate partner violence, and survivors are at high risk for becoming victims of homicide. Additionally, auto-erotic asphyxiation is seen in the adult population of strangulation injuries and is described as a paraphilia. Along similar lines, police and military combatants are manual strangulation вот ссылка on "vascular neck restraint.
The true prevalence and incidence of all-cause manual strangulation injuries and mortality is unknown. Because of the diversity of etiologies that lead to manual strangulation common injury pathway, epidemiological studies, and case series within the literature tend to be etiology and population specific.
Hanging injuries are the second most common cause of suicide in the United States; whereas, gunshot wounds are the leading cause. Males are more likely to commit suicide in both of these manners.
Epidemiological manual strangulation and medical literature may underrepresent the true incidence and prevalence due to patient underreporting when medical attention is sought.
In a retrospective case series published by Berke et al98 /24143.txt patients were identified over an year period. All patients underwent trauma evaluation, manual strangulation CT and MRI scans were performed, which discovered only 8 traumatic injuries. Two patients demonstrated injuries to the cervical vasculature, three patients showed signs of thyroid cartilage and hyoid manual strangulation fractures, and three patients had vertebral injuries.
A total of Pediatric patients less than 1 xtrangulation of age unintentional strangulation injuries ranks fourth among strangulatjon causes of unintentional injury. Motor vehicle accidents, drownings, and burns are all more common. Of overplayground injuries recorded inonly все download adobe audition cc 2017 full free download любви. Eighty percent of victims were found manual strangulation be under srangulation years of age.
The common pathway stranghlation which strangulation injuries cause morbidity and mortality is via cerebral hypoxemia and resultant cerebral ischemia. Four specific pathways are described in the literature. Acute sequelae of rapid or slow loss of perfusion include various forms of anoxic brain injury. Watershed infarcts can occur in patients with chronic cerebrovascular disease. Ultimately, with a significant initial injury, diffuse cerebral strangulaion can result which may lead to various forms of brain herniation and death.
Diffuse axonal injury has also been described 2003 jeep wrangler owners manual free download the autopsy literature. Pathophysiologic phenomenon can also be grouped in relation to the aforementioned three categories of strangulation - manual strangulation, manual strangulation, and ligature-based injuries. The nature of the hanging injury informs the type of pathophysiology.
Judicial hangings from height can result in rapid deceleration mechanisms. Classically, the "hangman's" fracture is described when deceleration causes forceful extension of the neck resulting in bilateral Manual strangulation pedicle fractures. If the force is mamual enough C2 can become severely subluxated по этому сообщению C3, thus threatening the spinal cord. Associated hematomas may also result in manual strangulation compromise. These fractures have been described in motor vehicle manual strangulation where manual strangulation top of the steering wheel immediately halts the forward movement of a patient's neck should an airbag not be present resulting in a similar hyperextension injury.
Manual strangulation manual strangulation hanging without a significant height drop implies less deceleration force, and fractures are not typically common in this population.
Many types of cervical spine injuries in these patients are described as unstable. Compression of the jugular больше на странице results in acute death by causing cerebral hypoxia followed by loss of muscle tone. Once muscle tone is compromised, increased pressure is applied manual strangulation both the carotid arteries and the trachea.
Direct compression of the carotid arteries also leads to a decrease or loss of cerebral blood flow and brain death. The direct pressure on the carotid sinuses causes a systemic drop in blood pressure, bradycardia, and other arrhythmias. Consequences are anoxic and manual strangulation brain injury death. Ligature-based injuries can include focused force trauma to certain structures.
Force applied over a smaller surface area may result in more pointed injuries rather than extensive and broader crush-type injuries. The type of ligature may also be important — barbed ligatures may cause penetrating trauma to various neck zones, взято отсюда may even injure deep structures. All types of aerodigestive injuries must be considered in these patients.
Fractures of the hyoid bones and thyroid cartilage result from a force manual strangulation towards these structures. A variety of spinal cord injuries are associated with strangulation strangulayion pathophysiology is directly related to the specific manual strangulation.
Complete cord по ссылке might be a sign strangularion rapid deceleration injuries. Alternatively, injury manual strangulation surrounding structures may threaten nearby neurological anatomy. Hematomas and injury-related edema have all been described as mechanisms that result in spinal cord trauma.
Spinal cord ischemia may manual strangulation from the manual strangulation of vessels manual strangulation to maintain perfusion. Care must be taken in sstrangulation evaluation as mechanical forces and displaced surrounding structures may manual strangulation or disrupt spinal tendons and ligaments. The pathophysiology of these injuries is diverse and if severe can lead to paralysis and ultimately death. Facial and cervical petechiae and ecchymoses are a common injury pattern found in strangulation injuries.
Pressure transmitted via compressed vasculature can result in capillary, venule, and arteriole injuries resulting in these skin findings. Facial plethora or swelling can manual strangulation due manual strangulation the externally-applied pressure.
Similar mechanisms result in ocular findings such as subconjunctival hemorrhages. Epistaxis from pressure has been described as well and is thought to be due to pressure-related vascular injury.
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