Hanging Injuries and Strangulation Treatment & Management

Updated: Dec 03, 2018
  • Author: William S Ernoehazy, Jr, MD, FACEP; Chief Editor: Trevor John Mills, MD, MPH  more...
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Treatment

Emergency Department Care

Assessment and treatment of airway status and breathing is paramount. In assessing the patient prior to possible endotracheal intubation, the likelihood of spinal cord injury increases substantially in hanging victims whose drop was equal to or greater than their height, even in incomplete hangings. Fluid resuscitation must be performed judiciously, given the risk of subsequent ARDS and cerebral edema.

Monitor the patient for cardiac arrhythmias.

Endotracheal intubation may become necessary with very little warning.

Cricothyroidotomy is indicated for any patient with airway deterioration, should endotracheal intubation be unsuccessful.

If associated neck injuries render cricothyroidotomy difficult, percutaneous translaryngeal ventilation may be used to temporarily oxygenate a patient. Definitive airway management (laryngotomy) must follow swiftly.