Hanging

Hanging is one of the topics that comes up every now and then on an exam and infrequently into the emergency department.

What are the key points?

2 Types of Hangings

• Suspension: rope tied around the neck and the person suspended so that the ligatures tighten. These are the most common forms of hanging presentation into the emergency department.
• Drop: The body is dropped from a distance with the aim of causing cervical spine fracture and spinal cord injury. This is an example of judicial hanging.

What are the injuries that occur?

• Cervical Injuries
  • In < 1%
  • Hangman fractures occur if the drop is greater than the patients height
• Vascular Injuries
  • Venous obstruction initially then arterial obstruction
  • Venous cerebral infarction
• Other fractures
  • Thyroid/Cricoid cartilage
• Aspiration causing ARDS