The 2023 – 2024 Trauma Webinar Series – Part Eight: Invisible and Under-Reported: Non-Fatal Strangulation

Tuesday, April 30, 2024, 12:00 PM - Friday, April 30, 2027, 1:00 PM

AMA PRA Category 1 Credits™ (1.00 hours), ANCC Nursing Contact Hours (1.00 hours), CME-Designated Participation Credit (1.00 hours)

Non-fatal strangulation is a dangerous and potentially fatal event and is being diagnosed in increasing numbers across the United States. It is often invisible and overlooked by healthcare providers and will likely be under-reported by our patients. Healthcare clinicians receive minimal training in the identification and response to non-fatal strangulation. Join us as we learn more about non-fatal strangulation and the associated risk factors this presents for adverse health outcomes, including the risk of being murdered.

Presenter

Janet Carroll, RN, CEN, SANE-A, SANE-P

About our Presenter

Janet has been a nurse for 25 years working as an Emergency Department Registered Nurse and is currently the Nurse Manager of the Forensic Nursing Program at Dartmouth Hitchcock Medical Center. She is also serving as the New Hampshire Statewide SANE Program Director. Since she became a Sexual Assault Nurse Examiner (SANE) in 2005 she has provided over thousand medical forensic exams in New Hampshire and Vermont hospitals.  In 2014, Janet was able to expand the SANE program at DHMC into a Forensic Nursing program, providing specialized care to patients that have experienced domestic violence, vulnerable adult abuse, human trafficking, interpersonal violence, and strangulation.  In addition to several local awards, Janet received national recognition and was named the Frontline Forensic Nurse of the Year by the International Association of Forensic nurses in 2019 and named the Emergency Nurse of the Year by NH Magazine in 2021.   

1. Discuss the plan of care for patients who have experienced non-fatal strangulation.

In support of improving patient care, Dartmouth Health is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

American Nurses Credentialing Center (ANCC)
Dartmouth Health designates this Enduring Material for a maximum of 1.00 ANCC contact hour. 

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Resources

• International Association of Forensic Nursing:  Nonfatal Strangulation Toolkit, Documentation Tools: https://www.forensicnurses.org/page/STDocs
  
  
• Strangulation Institute, Great brochures & Graphics: https://www.strangulationtraininginstitute.com
  
  
• DV specific to women: Danger Assessment tool: http://www.dangerassessment.org
  
  

Bibliographic Sources

• Campbell, J. C., Webster, D. W., & Glass N. (2009). The danger assessment: Validation of a lethality risk assessment instrument for intimate partner femicide. Journal of Interpersonal Violence, 24(4), 653–674.
  
  
• Christe, A., Thoeny, H., Ross, S., Spendlove, D., Tshering, D., Bollinger, S., Grabherr, S., Thali, M. J., Vock, P  ., & Oesterhelweg, L. (2009). Life-threatening versus non-life-threatening manual strangulation: Are there appropriate criteria for MR imaging of the neck? European Radiology, 19(8), 1882–1889.
  
  
• Gashco,D, et.al. (2020). The value of MRI for assessing danger to life in nonfatal strangulation. Forensic Imaging, 22, 200398.
  
  
• Ernoehazy, W., Jr. (2016, January 19). Hanging injuries and strangulation. Medscape.
  
  
• Faugno, D., Waszak, D., Strack, G. B., Brooks, M. A., & Gwinn, C. G. (2013). Strangulation forensic examination best practice for health care providers. Advanced Emergency Nursing Journal, 35(4), 314–327.
  
  
• Hawley, D., McClane, G. E., & Strack, G. B. (2001). A review of 300 attempted strangulation cases. Part III: Injuries in fatal cases. The Journal of Emergency Medicine, 21(3), 317–322.
  
  
• Iserson, K. V. (1984). Strangulation: A review of ligature, manual, and postural neck compression injuries. Annals of Emergency Medicine, 13(3), 179–185.
  
  
• Kilne-Hath,b., et.al. (2021). Pediatric hanging and strangulation:  is vascular injury a true risk?,  Pediatric Radiology, 51, 1889-1894.
  
  
• Kornblum,RN. (1986).  Medical Analysis of Police Choke Holds and General Neck Trauma Part 1.  Trauma, 5:7-64.
  
  
• Strack, G. B., & McClane, G. (1999). How to improve your investigation and prosecution of strangulation cases (2nd ed.). D. C. James (Ed.). San Diego, CA. Retrieved  from http://www.ncdsv.org/images/strangulation_article.pdf
  
  
• Taliaferro, E., Hawley, D., McClane, G., & Strack, G. (2009). Strangulation in intimate partner violence. In C. Mitchell & D. Anglin (Eds.), Intimate partner violence: A health-based perspective (pp. 217–236). New York, NY: Oxford University Press.
  
  
• Williamson, F., et.al. (2021). Vascular injury is an infrequent finding following non-fatal strangulation in two Australian trauma centres.  Emergency Medicine Australasia, doi:10.1111/1742-6723.13863
  
  

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Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
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Dartmouth Health
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Dartmouth Health adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education.  Any individuals in a position to control the content of a CE activity, including planners, faculty, authors, or others are required to disclose all financial relationships with ineligible companies^.  All relevant financial relationships have been mitigated prior to the commencement of the activity.

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