Emergency nursing

Advanced Strangulation Training

Strangulation has been identified as one of the most lethal forms of domestic violence and sexual assault: unconsciousness may occur within seconds and death within minutes. When domestic violence perpetrators choke (strangle) their victims, not only is this felonious assault, but it may be an attempted homicide.


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Strangulation is an ultimate form of power and control where the batterer can demonstrate control over the victim’s next breath: it may have devastating psychological effects or a potentially fatal outcome.


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The Emergency Department Neuro Exam – Three YouTube Videos

The Emergency Department Neuro Exam – Three YouTube Videos

https://www.tomwademd.net/the-emergency-department-neuro-exam-three-youtube-videos/
— Read on www.tomwademd.net/the-emergency-department-neuro-exam-three-youtube-videos/

Strangulation of Adult & Pediatric Patients

As a trauma nurse that is cross-trained with a master of forensic science degree, I spend a lot of time thinking about recognition & assessment of strangulation patients. •

Strangulation and Domestic Violence

Strangulation has been identified as one of the most lethal forms of domestic violence. It is one of the best predictors for subsequent homicide. Prior strangulation increases the odds of strangulation homicide by more than seven times. For perpetrators, strangulation is the ultimate form of power and control. However, because there are often no visible injuries, patients, physicians, and law enforcement often minimize the possible health consequences of reported strangulation.

Pathophysiology

The vasculature of the neck is relatively unprotected and vulnerable to injury and vascular occlusion. The application of 4.4 pounds of pressure to the jugular veins causes venous outflow obstruction from the brain and thus stagnant hypoxia. Eleven pounds of pressure to the carotid arteries can cause loss of consciousness in approximately 10 seconds. Compression of the trachea requires significantly more force: 33 pounds of pressure for occlusion and 35 pounds to fracture tracheal cartilage.

Strangulation can be fatal in as little as four to five minutes. Mechanisms in addition to hypoxia due to vascular occlusion have been proposed. Pressure on the carotid body may cause bradycardia and subsequent cardiac arrest. Delayed mortality may be caused by carotid artery dissection, aspiration, postobstructive pulmonary edema, acute respiratory distress syndrome, or tracheal injury.

📓: ACEP Now, Heather V. Rozzi, MD, FACEP; and Ralph Riviello, MD, MS/April 2019

A Link To “The 10 books every paramedic should own”

A Link To “The 10 books every paramedic should own”

https://www.tomwademd.net/a-link-to-the-10-books-every-paramedic-should-own/
— Read on www.tomwademd.net/a-link-to-the-10-books-every-paramedic-should-own/