Struggling to Breathe: Hidden Dangers of Nonfatal Strangulation for Women Victims of Intimate Partner Violence
Peter Mertin, Nicola Eastaff-Leung
Nonfatal strangulation (NFS) is the application of external pressure to the neck constricting blood flow to the brain and/or airway. Depending on the duration and severity of the assault, NFS can result in consequences encompassing physical injuries, to a range of neurological insults and emotional effects. Strangulation is also one of the best predictors for homicide in relationships characterised by intimate partner violence (IPV). As the majority of women experiencing NFS do not appear to seek medical care following an assault, prevalence rates are difficult to ascertain.
However, evidence based on a small number of epidemiological studies indicates rates could be as high as 68% in some populations of women abused in violent relationships, with many women being strangled on multiple occasions. While the low level of reporting of abuse by those victims who present to primary health care (PHC)
facilities can make the recognition of NFS difficult, it is important that PHC providers understand the range of signs and symptoms commonly associated with NFS and question directly about IPV. Management must include the careful documentation of the assault and presenting difficulties, as well as the formulation of a safety plan.
