References
The hanging/hanged patient and relevance to pre-hospital care
Abstract
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.
Hanging is one of the most common suicide methods in England and Wales (Office for National Statistics, 2011), with 51.7% of suicides (and deaths likely but not proven to be suicide) being by hanging. In 2010, over 4 200 people ended their lives by suicide in England (Department of Health, 2012), of which around 2 171 people hanged themselves. Gunnell et al (2005) propose that hanging is one of the most lethal forms of suicide attempt and estimate the fatality being around 70%.
Bennewith et al (2005) state that suicide by hanging in prison or psychiatric units account for only 6% of the total hanging suicides in the 6-month period and locations they studied. Thus, 94% of hanging suicides take place in the community, potentially in people's homes or workplaces. Bennewith et al (2005) further divide the locations, as can be seen in Table 1.
Subscribe to get full access to the Journal of Paramedic Practice
Thank you for visiting the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.
What's included
-
CPD Focus
-
Develop your career
-
Stay informed