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Emergency airway management in hanging victims
T P Aufderheide1, C Aprahamian, J R Mateer
1Division of Emergency Medicine, Medical College of Wisconsin, Milwaukee.
Annals of Emergency Medicine
|November 1, 1994
Summary
Cervical-spine injury is rare in hanging victims treated by paramedics. The primary concern in emergency airway management should be cerebral hypoxia, not spinal cord injury.
Area of Science:
- Emergency Medicine
- Trauma Care
- Forensic Pathology
Background:
- Hanging is a significant cause of traumatic death.
- Appropriate emergency airway management for hanging victims requires understanding injury patterns.
Purpose of the Study:
- To determine the incidence and demographics of hanging victims.
- To identify clinical indicators of survival.
- To define appropriate emergency airway management, focusing on cervical-spine fractures.
Main Methods:
- Retrospective review of medical examiner, paramedic, and hospital records (1978-1990).
- Analysis of 306 hanging victims within an urban paramedic system.
- Focus on patients transported to emergency departments (EDs) and receiving endotracheal intubation.
Main Results:
- Hanging incidence was 0.19% of all cases reviewed.
- Survivors treated by paramedics were typically male, attempted suicide in public, and used bedding/clothes.
- No documented cervical-spine or spinal cord injury in transported hanging victims.
Conclusions:
- Cervical-spine injury is uncommon in nonjudicial hanging victims reaching the ED.
- Cerebral hypoxia is the likely cause of death, necessitating focus on oxygenation.
- Endotracheal intubation after neck stabilization is appropriate emergency airway management.