'I thought I was about to die': Management of non-fatal strangulation in general practice

Abstract

Awareness of the significance of non‑fatal strangulation is increasing in health and justice settings. While approximately half of patients strangled will sustain no immediate physical injury, strangulation has potential significant sequelae such as carotid dissection, hypoxic brain injury and laryngeal injury. Non-fatal strangulation by an intimate partner increases homicide risk by 7.48 times. General practitioners have a key role in identification, education and appropriate treatment. OBJECTIVE: The aim of this article is to provide an understanding of strangulation and its associated risks, to inform decision making regarding assessment, investigation and appropriate patient referral and safety netting. DISCUSSION: Informing patients of the increased risk of future homicide if strangled by an intimate partner may prevent death. Awareness of the red flag signs and symptoms, from subtle bruises or petechiae to significant oedema, focal neurological deficits and cognitive impairment, aids decision making regarding referrals and imaging as well as informing documentation for legal purposes.