Insight into pathophysiology and management of partial hanging
Keywords:Hanging, Partial hanging, Suicide methods
Background: Many methods are available for committing suicide. Hanging is one of the methods to committee suicide. The incidence of hanging for committing suicide is increasing. This is a retrospective study carried out at KDN Gohil Hospital, Navsari (Gujarat) to know about the outcome of this type of suicidal attempts and to review the management of such type of patients. Management of this type of injury is not found in many standard textbooks, so this small study will help to compare mortality rate and management protocol with other larger studies.
Methods: All patients with history of hanging and accidental strangulation were brought to hospital, after they were released from strangulating agent were included in this study. Various aspects of agents used for hanging, the characteristic findings and management protocol of the patients were studied retrospectively.
Results: Results in the form of survival rate and occurrence of complications. Out of 30 patients 24 patients survived and 6 died. Non had cervical spine injury. One patient had laryngeal injury and developed laryngeal stenosis.
Conclusions: Suicidal hanging is different from judicial hanging. Most of the time suicidal hanging survival are high; once the patient is brought to the hospital alive in time. Early endotracheal intubations, management of hypotension, ventilator support and anti-oedema drugs are main steps of management.
Gunnell D, Bennewith O, Hawton K, Simkin S, Kapur N. The epidemiology and prevention of suicide by hanging: a systematic review. Int J Epidemiol. 2005;34(2):433-42.
Gandhi R, Taneja N, Mazumder P. Near hanging: Early intervention can save lives. Ind J Anaesth. 2011;55(4):388.
Iserson KV. Strangulation: a review of ligature, manual, and postural neck compression injuries. Annal Emerg Med. 1984;13(3):179-85.
Boots RJ, Joyce C, Mullany DV, Anstey C, Blackwell N, Garrett PM, et al. Near-hanging as presenting to hospitals in Queensland: recommendations for practice. Anaesth Inten Care. 2006;34(6):736-45.
Sanchez LD, Wolf RE. Hanging and strangulation. In: Wolfuson AB, Hendey GW, Ling LJ, eds. Clinical Practice of Emergency Medicine. 5th ed: Wolter Kluwer/Lippincott Williams & Wilkins; 2009: 327-329.
Kaki A, Crosby ET, Lui AC. Airway and respiratory management following non-lethal hanging. Canad J Anaesth. 1997;44(4):445-50.
Adams N. Near hanging. Emerg Med. 1999;11:17-21.
McHugh TP, Stout M. Near-hanging injury. Annal Emerg Med. 1983;12(12):774-6.
Hausmann R, Betz P. Delayed death after attempted suicide by hanging. Int J Legal Med. 1997;110(3):164-6.
DiMaio VJ. Asphyxia. In: DiMaio VJ, DiMaio D, eds. Forensic Pathology. 2nd ed: CRC Press; 2001: 229-275.