Faculty Collaboration Database

Emergency airway management in hanging victims. Ann Emerg Med 1994 Nov;24(5):879-84

Date

11/01/1994

Pubmed ID

7978561

DOI

10.1016/s0196-0644(94)70206-3

Scopus ID

2-s2.0-0028006908 (requires institutional sign-in at Scopus site)   44 Citations

Abstract

STUDY OBJECTIVE: To determine the incidence, demographics, clinical indicators of survival, and frequency of cervical-spine fractures to define appropriate emergency airway management in hanging victims.

DESIGN: Medical examiner records, paramedic reports, and emergency department and hospital medical records were reviewed retrospectively for the period January 1, 1978, to January 1, 1990.

SETTING: Urban paramedic system with nine receiving hospitals.

PARTICIPANTS: A total of 160,724 medical examiner and paramedic records were reviewed to identify a total study population of 306 hanging victims. One hundred eighty-two victims (59%) were found dead at the scene, and the emergency medical system was not notified. An additional 57 (19%) were seen by paramedics and declared dead at the scene. Sixty-seven (22%) were treated and transported to nine receiving EDs; 39 of these 67 received oral or nasal endotracheal intubation.

RESULTS: The incidence of hanging was 0.19% of all medical examiner cases and paramedic runs during the 12-year study. Those hanging victims who survived to receive paramedic transport and treatment by physicians were typically male and attempted suicidal hanging in a public place (most frequently jail) with available bedding or clothes. No hanging victim treated and transported by paramedics had documentation of cervical-spine or spinal cord injury.

CONCLUSION: In nonjudicial hanging victims seen by paramedics and transported to an ED, cervical-spine injury is rare. Cerebral hypoxia rather than spinal cord injury is the probable cause of death and should be the primary concern in treatment of this patient population. Following external stabilization of the neck, nasal or oral endotracheal intubation is appropriate emergency airway management in hanging victims.

Author List

Aufderheide TP, Aprahamian C, Mateer JR, Rudnick E, Manchester EM, Lawrence SW, Olson DW, Hargarten SW

Authors

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin
Stephen W. Hargarten MD, MPH Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Airway Obstruction
Cause of Death
Cervical Vertebrae
Emergencies
Female
Humans
Hypoxia, Brain
Incidence
Intubation, Intratracheal
Male
Middle Aged
Population Surveillance
Retrospective Studies
Spinal Fractures
Suicide, Attempted
Survival Rate
Wisconsin