POTD: The Hanging Patient

Clinical scenario and question: 30 year old male arrives by EMS with a C-collar after trying to hang himself.  Ligature marks are seen around his neck.  He is currently awake and talking with a hoarse voice, roommate that found him reports an episode of cyanosis and loss of consciousness.  What injuries should I be concerned about for this patient after a nonfatal hanging?  

This patient is considered a NONjudicial hanging.


Potential injuries: 

  • Hyoid bone fracture
  • Cricoid or thyroid cartilage injury
  • Airway edema
  • Cervical spine injury (hangman’s fracture)
  • Spinal cord injury
  • Hypoxic cerebral injury
  • Vascular injury (dissection/thrombosis)
  • Late findings include:
    • Aspiration pneumonia
    • Neurogenic pulmonary edema (from hypoxic cerebral injury)
    • Post-obstructive pulmonary edema
    • ARDS

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