Have you been strangled? Or smothered so you couldn’t breathe?
Professionals, the public and victims are misinformed about strangulation.
- Most victims of strangulation will not have visible external injuries.
- Fatal strangulation can occur without any external evidence of violence on the human body.
- The victim may die hours, days or months after the strangulation event.
- Non-fatal strangulation can have serious immediate and long-term health consequences including brain damage.
- A woman who survives one strangulation event is 700% more likely to be strangled again and 800% more likely to be killed later.
We recommend that all church leaders familiarize themselves with the dangers of non-fatal strangulation.
DO ask the victim if her partner has choked or strangled her. It is common for domestic violence and strangulation victims to minimize what has happened to them. She may not share information with you unless you ask.
An MRI can detect internal injuries. A CAT scan using a contrast dye (called a CT-A) is also very helpful in finding injuries to the veins and arteries of the head and neck. Encourage the victim who has been strangled to request a MRI and CT-A if possible.
The following videos discuss non-fatal strangulation and are helpful for victims, professionals and the public.
Nurse Joanna is compassionate and easy to understand. Her tone is perfect for victims.
Strangulation: Detection & Investigation – Brian Bennett
Brian Bennett is a domestic violence instructor with the State Criminal Justice Academy in South Carolina and an advisor in the field of domestic violence and sexual assault.
Note: New research is constantly revealing new information. The video information was valid at the time of creation but may not reflect all current research findings.
Terminology tip: Brian Bennett mentions petechial hemorrhage. A petechial hemorrhage is a tiny pinpoint red mark that is an important sign of asphyxia caused by some external means of obstructing the airways. They are sometimes also called petechiae.
A while ago, Bennett wrote this on our ACFJ Facebook page:
and Bennett also has noticed that:
Domestic violence within the church seems to be a taboo subject. Many churches are unwilling to approach the issue in spite of having numerous opportunities to do so. I see many churches having women’s and men’s conferences or couples conferences instructing both to have a servant’s heart for another and keeping God first in all things. Much talk on the purpose of marriage, the mirrored relationship of Jesus to God and God to the people…and more! Not one mention though of how to deal with domestic violence. No matter the size of one’s church, statistics tell us there is someone who is or has experienced domestic violence!
Tom Tremblay is a retired Chief of Police from Burlington, Vermont and the former Commissioner of the Vermont Department of Public Safety. He has been an advisor and instructor in the investigation of domestic violence and sexual assault.
We are super-impressed by the way Tom Tremblay recommends how to question victims in a way that understands their distress and how the trauma might have affected them.
Also by Tom Tremblay: Sexual Assault: A Trauma Informed Approach to Law Enforcement First Response.
And we’ve added Nurse Joanna and Brian Bennett’s videos to our Safety Planning page since we think they are particularly helpful for victims.
Thank you to Brian Bennett for reviewing this post for us and for his additions!
More resources on Strangulation and Choking
Strangulation Training Institute – this site is recommended by Brian Bennett
Strangulation Assessment Card (PDF) – can be used by professionals or victims of strangulation
Strangulation Investigation Questions (PDF) – for anyone who a victim of domestic abuse might seek help from
Signs and Symptoms of Strangulation (PDF, Version 1 in English)
Signs and Symptoms of Strangulation (PDF, Version 2 in English)
Signs and Symptoms of Strangulation (PDF, Version 1 in Spanish)
Signs and Symptoms of Strangulation (PDF, Version 2 in Spanish)
Facts Victims of Strangulation (Choking) Need to Know – Brochure (PDF in English)
Facts Victims of Strangulation (Choking) Need to Know – Brochure (PDF in Spanish)
Intimate Partner Violence & Strangulation in the Deaf Community – a video with subtitles for the hearing impaired.
No Place for a Smile (PDF) – an article for dentists.
Dentists routinely assess a patient’s head, neck and mouth. They have a unique and excellent opportunity to recognize whether or not a patient is being abused. This article seeks to enlist the collaboration of the dental community in the effort to prevent domestic/intimate partner violence and provide more information about the signs and symptoms of domestic violence injuries, including strangulation, which is often overlooked by medical and dental professionals.
Update added 30 April 2018:
The shocking rate of brain injuries in domestic violence — An Australian study found that in domestic violence admissions to hospital, 40% of victims had sustained a brain injury.