Karen Gubbins
Journal of Paramedic Practice, Vol. 8, Iss. 6, 03 Jun 2016, pp 290 - 293

Death and injury from hanging is a complex situation which requires careful and
appropriate assessment and management in the pre-hospital environment. It is
arguably an area of limited understanding and therefore may not be assessed
and managed in the most effective manner. Most hanged/hanging patients
will be found in their homes, rather than in institutions. It could be argued that
due to prevalence as a suicide method, the majority of pre-hospital ambulance
service staff will respond to at least one hanged or hanging patient within their
careers, thus a greater understanding will benefit both clinician and patient.
Patients who attempt or achieve suicide will rarely achieve fracturing the spine
and severing the spinal cord, bringing into question the requirement for the
traditional cervical collar and spinal immobilisation techniques. Death from
asphyxiation and carotid/vagal reflex require consideration and management as
does raised intracranial pressure, which is likely to occur.

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