Hanging Injuries and Strangulation Follow-up
- Author: William Ernoehazy, Jr, MD, FACEP; Chief Editor: Trevor John Mills, MD, MPH more...
Further Outpatient Care
Psychiatric support for near-hanging survivors is recommended, as these patients are prone to depression, personality disorders, and violence.
Further Inpatient Care
All patients who have required endotracheal intubation for airway management must be admitted to a critical care unit.
Even if the initial presentation is clinically benign, all near-hanging victims and patients with evidence of vascular compromise secondary to strangulation should be admitted for 24 hours observation to watch for delayed airway and pulmonary complications.
Inpatient & Outpatient Medications
Phenytoin may help prevent additional insult from cerebral ischemia and to treat hanging-induced seizures.
Once stabilized, patients who have sustained a spinal cord injury should be transferred to a designated spinal cord center.
Caution parents about the dangers of postural asphyxiation in toddlers. Encourage childproofing of the home.
Patients who present with injuries caused by "breath play," either autoerotic or thrill-seeking, should be educated in the risks of sudden death, which can occur.
Complications include the following::
- Respiratory complications: These are the major cause of delayed mortality in near-hanging victims. Both aspiration pneumonia and ARDS may develop, complicating the clinical course.
- Tracheal stenosis
- Neurologic sequelae: A wide array of complications may occur in survivors of strangulations and near-hangings, including muscle spasms, transient hemiplegia, central cord syndrome, and seizures. Spinal cord injury can also cause long-term paraplegia or quadriplegia and short-term autonomic dysfunction.
- Scarring of neck tissue
- Psychiatric disturbances: Psychosis, Korsakoff syndrome, amnesia, and progressive dementia all have been reported after surviving a hanging or strangulation. Nearly all patients who have undergone strangulation or near-hanging demonstrate restlessness and a propensity for violence.
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