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Cardiac arrest after hanging: A scoping review.

Thomas Fisher1, Clodagh Beattie2, Quentin Otto2

  • 1Stoke School of Anaesthesia, West Midlands Deanery, UK.

Resuscitation
|January 23, 2025
PubMed
Summary

Cardiac arrest after hanging is a critical factor for poor outcomes. Survival with good function is rare in these patients, highlighting a need for more research.

Keywords:
Advanced life supportBasic life supportCardiac arrestHangingNear-hangingResuscitationSpecial circumstances

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Area of Science:

  • Emergency Medicine
  • Cardiology
  • Toxicology

Background:

  • Hanging is a frequent cause of suicide and asphyxial cardiac arrest.
  • Limited data exist regarding the optimal treatment for cardiac arrest following hanging.
  • This scoping review examines interventions and outcomes for patients with and without cardiac arrest after hanging.

Approach:

  • A comprehensive literature search was conducted across Medline, Embase, and Cochrane databases up to May 12, 2024.
  • Articles were included if they focused on non-judicial hanging in adults or children, involved cardiac arrest, and reported functional or survival outcomes.
  • Forty-five observational studies, primarily from high-income countries, were included after screening 855 articles.

Key Points:

  • Survival with favorable functional outcomes was uncommon in patients experiencing cardiac arrest post-hanging.
  • Conversely, patients without cardiac arrest after hanging demonstrated a high rate of survival with good function.
  • Injuries to the cervical spine, airway, and vasculature were infrequently reported.
  • No interventions were identified that demonstrably improved survival after return of spontaneous circulation.

Conclusions:

  • There is a significant paucity of data to guide the treatment of cardiac arrest subsequent to hanging.
  • Cardiac arrest emerges as a crucial determinant of adverse outcomes in hanging incidents.
  • Future research should standardize the reporting of outcomes for cardiac arrest patients following hanging, adhering to the Utstein template.