HWN Suggests

The epidemiology and prevention of suicide by hanging: a systematic review

Only a small proportion (around 10%) of hanging suicides occur in the controlled environments of hospitals, prisons, and police custody; the remainder occur in the community. The most commonly used ligatures (rope, belts, flex) and ligature points (beams, banisters, hooks, door knobs, and trees) are widely available; thus prevention strategies focused around restriction of access to means of hanging are of limited value. Around 50% of hanging suicides are not fully suspended—ligature points below head level are commonly used. Case fatality following attempted suicide by hanging is around 70%; the majority (80–90%) of those who reach hospital alive survive.

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Articles of Interest

Clinical Focus: Strangulation and Hanging Injuries

Cervical spine fractures are well-documented in judicial hangings but are thought to be exceedingly rare or non-existent in non-judicial hangings. However, one retrospective case review of near-hangings over a 10-year period at LA County and University of Southern California Medical Center found a cervical spine fracture incidence of nearly 5%. Cervical spine fractures are also uncommon in manual strangulation.

Managing the Hanging Injury

What are the issues to be immediately addressed, and of what complications should an emergency physician be aware?

Question and Answer: What Happens When Someone Is Hanged?

Though the airway can be compressed and breathing can be interrupted, the real cause of loss of consciousness and death in most hangings is compression of the carotid arteries, which blocks blood flow to the brain. Except for judicial (legally directed) hangings, fractures of the cervical vertebrae (spinal bones of the neck) are uncommon. The reason is that these fractures require that the body drop a sufficient distance to break them. How far is this? The answer depends upon several factors...

Strangulation Injuries

Strangulation is defined as the compression of blood or air-filled structures which impedes circulation or function. In this summary, strangulation will refer to compression of anatomical neck structures leading to asphyxia and neuronal death. Strangulation injuries can be divided into several categories. These include hanging injuries, manual strangulation, and ligature injuries

Death by Hanging: Implications for Prevention of an Important Method of Youth Suicide

The private nature of hanging means that there are rarely opportunities to prevent it in the period immediately before the fatal event. Earlier interventions will have to be considered. To prevent hanging as a means of suicide, we need to understand more about the difficulties experienced by some young men who are living in rural areas.

Epstein A Suicide—Or Murder? New York City Examiner Disputes Pathologist’s ‘Homicide’ Claim

“Hanging does not cause these broken bones, and homicide does. Usually two bones, even three, is a huge amount of pressure [that] was applied,” said Baden during his Fox & Friends appearance.

Epstein’s Broken Hyoid Bone Doesn’t Tell Us Much

It’s still much, much more likely that he died by suicide than that he was murdered.

Epstein’s Death Has a Simpler Explanation

Baseless speculation abounded after the accused sex trafficker died, but criminal-justice scholars point instead to a broader suicide problem.

Factors influencing the decision to use hanging as a method of suicide: qualitative study

Prevention strategies should focus on countering perceptions of hanging as a clean, painless and rapid method that is easily implemented. However, care is needed in the delivery of such messages as some individuals could gain information that might facilitate fatal implementation.

Hanging in There. Living beyond Hanging: A Retrospective Review of the Prognostic Factors from a Regional Trauma Center

Independent risk factors for poor outcomes in near-hanging trauma were identified. These factors include relationships between systolic BP, GCS categories, admission vitals, cervical spine injures with fracture, cerebral anoxia, cerebral injury, and pulmonary edema with survival.

Hanging to commit suicide in the developing world

Seventy-nine percent of suicides occur in developing countries and hanging is the second most likely method of suicide attempt in developing countries. Efforts to prevent hanging are hindered by the social stigma of depression and suicide and the lack of an effective prevention strategy.

Mechanism of death in hanging: a historical review of the evolution of pathophysiological hypotheses

The main pathophysiological theories described were respiratory asphyxia, interruption to cerebral blood flow because of occlusion of vessels in the neck, and cardiac inhibition secondary to nerve stimulation. The relative contributions of each of these theories to death in cases of hanging is still debated today.

Memo to Maliki

How to hang someone without embarrassing your country.

Suicide by hanging: Results from a national survey in Switzerland and its implications for suicide prevention

Hanging is a frequent suicide method, but developing measures to prevent suicide by this method is particularly challenging. The aim of this study is to gain new knowledge that would enable the design of effective of measures that would help prevent suicide by hanging.

The Busy Gallows Of Iran

Iran is the only country in the world that continues to execute children. 2008 saw six teenagers get the chair kicked from under them (that's right, hanging is the preferred method).

The Effective Factors on Survival in Near-Hanging

Neck hanging is one of the most lethal suicide methods. The morbidity and mortality due to hanging is usually associated with neck’s structure injury attached to a fall from height, venous obstruction and cerebral hypoxia time. Mortality is usually caused by respiratory failure in patients who recovered from hanging.

You think lethal injection is barbaric? These states still allow execution by hanging.

Who would have guessed that states like New Hampshire, Delaware, and Washington — better known for their love of the outdoors — would make up the hanging triumvirate of the United States?

Resources

10 Insane (but true) Facts about the French Guillotine

The guillotine is by far one of the most gruesome methods of execution. Also known as: Madame la Guillotine, la Dame (the Lady), la Veuve (the Widow), le Rasoir National (the National Razor), and Louisette, the guillotine is synonymous with ‘the Terror’ of the French Revolution, and it continues to both horrify and fascinate us. Some of these facts may surprise you. For instance, did you know that the famous French figure Marie Antoinette was sentenced to death and executed via guillotine blade right in the middle of Place de la Concorde

Radiopaedia

In suicidal hanging the forces exerted on the neck are usually lower than those seen in judicial hangings due to absence of the drop height in such hangings, making cervical spine injury less of a concern (see hangman fracture).