{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:25:04Z","timestamp":1791617104241,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T00:00:00Z","timestamp":1631145600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Non\u2010fatal strangulation assessment is challenging for clinicians as clear guidelines for evaluation are limited. The prevalence of non\u2010fatal strangulation events, clinical findings, frequency of injury on computed tomography angiogram (CTA) and outcomes across two trauma centres will be used to improve this assessment process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective observational study of adult presentations during 2\u2010year period to two major\u2010trauma referral hospitals and subsequent 12\u2009months to identify delayed vascular injury. Patients included using standardised search terms. Demographic data, clinical findings, radiological reports and outcomes were included for review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 425 patients were included for analysis. Self\u2010inflicted injury comprised 62.1%, with domestic violence (28.5%) and assault (9.4%) the remainder. Manual strangulation events 36.7% of overall presentations and 63.3% following ligature strangulation (ligature strangulation, incomplete and complete hanging). On examination soft signs present in 133 (31.2%) cases, commonly neck tenderness in isolation. No hard signs suggesting vascular damage. Vascular injury was demonstrated in three cases (0.7% of the total cohort and 1.5% of CTA scans completed), and all occurred in ligature strangulation events as a result of hanging. No patients had delayed vascular injury in the 12\u2010month period post\u2010initial presentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In non\u2010fatal strangulation presentations, the majority have subtle signs of neck injury on examination with inconsistent documentation of findings. Low rate of vascular injury overall (0.7%), and entirely in hanging events. No longer\u2010term vascular sequalae identified. Improving documentation focusing on hypoxic insult and evidence of airway trauma is warranted, rather than a reliance on computed tomography imaging to delineate a traumatic event in non\u2010fatal strangulation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.13863","type":"journal-article","created":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T06:28:40Z","timestamp":1631255320000},"page":"223-229","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Vascular injury is an infrequent finding following <scp>non\u2010fatal<\/scp> strangulation in two Australian trauma centres"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5476-1791","authenticated-orcid":false,"given":"Frances","family":"Williamson","sequence":"first","affiliation":[{"name":"Emergency and Trauma Centre and Trauma Service Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"},{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"},{"name":"Jamieson Trauma Institute Metro North Hospital and Health Service  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Collins","sequence":"additional","affiliation":[{"name":"Emergency Department Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Dehn","sequence":"additional","affiliation":[{"name":"Emergency Department Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaela","family":"Doig","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre and Trauma Service Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-018-0559-1"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000455391"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199605000-00007"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199810000-00003"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.06.187"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2019.07.018"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10140-019-01690-3"},{"key":"e_1_2_10_9_1","unstructured":"Queensland Legislation. Criminal Code (Choking in Domestic Settings) and Another Act Amendment Bill 2020. 2020. [Cited 20 Aug 2021.]Available from URL:https:\/\/www.legislation.qld.gov.au\/view\/whole\/html\/bill.first\/bill-2020-007"},{"key":"e_1_2_10_10_1","unstructured":"Northern Territory of Australia.Justice Legislation Amendment (Domestic and Family Violence) Act.2019. [Cited 20 Aug 2021.] Available from URL:https:\/\/parliament.nt.gov.au\/__data\/assets\/pdf_file\/0011\/761555\/Justice\u2010Legislation\u2010Amendment\u2010Domestic\u2010and\u2010Family\u2010Violence\u2010Bill\u20102019\u2010.pdf"},{"key":"e_1_2_10_11_1","unstructured":"Training Institute on StrangulationPrevention. Investigating domestic violence strangulation. 2017. [Cited 20 Aug 2021.] Available from URL:https:\/\/www.strangulationtraininginstitute.com\/investigating\u2010domestic\u2010violence\u2010strangulation\/"},{"key":"e_1_2_10_12_1","volume-title":"Guideline on Hanging and Strangulation","author":"Fryer D","year":"2011"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2007.02.065"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002668"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181c1c1d6"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2018170140"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1557085116653181"},{"key":"e_1_2_10_18_1","unstructured":"Queensland Centre for Domestic and Family Research Newsletter.Summer 2019. 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