Monday 16 January 2012

Emedinews:Insights on Medicolegal issues:Hanging is almost always suicidal


  • Apart from the now rare ‘lynching’, hanging is almost always suicidal or accidental, the former being by far the most common.

  • Hanging has many features in common with ligature strangulation. Death is, however, more often caused by reflex cardiac arrest from pressure on the carotid structures.

  • Many more victims of hanging are found to have pale faces, rather than the congested, hemorrhagic appearance of the slower asphyxial type of death.

  • The rapid onset of heart stoppage may antedate any evidence of congestive or ‘asphyxia’ signs, causing death immediately or within seconds, or at any time thereafter.

  • Overstimulation of nerve endings in the carotid sinus or adjacent arterial sheath may be brought about by direct pressure from fingers or from a ligature during strangulation or hanging-or from a blow directed at the side of the neck.

  • Severe pain, such as a blow on the larynx or genitals, may also trigger a ‘vagal response’. absence of congestion, cyanosis and petechial, the pale faces indicating that cardiac arrest had taken place before the congestive signs had time to appear. Electrostimulation has an excellent chance of revival.
  
Reference…………………..James and Silocks (1992), In a 15-year survey of hanging in Cardiff, found congestive-petechial features in 27 percent, being related to the completeness of suspensions

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