Study of Pathophysiology and Management of Partial Hanging

Background: Accidents and suicides claim a large number of human lives every year. Each unnatural death either due to accident or suicide is a personal tragedy that permanently takes the life of an individual and has a continuing ripple effect, dramatically affecting the lives of families, friends and communities. Every year more than 100000 people commit suicide in India. National crime records bureau- Ministry of home affairs-Govt. of India (NCRB) collects data on suicide from police recorded cases. A total of 1, 39,123 suicides were reported in the country during 2019 [1]. This figure is 3.4% more than no. of suicides in 2018.There are many methods of committing suicide. The means adopted for committing suicide varies from the easily available and effective means such as consumption of poison, jumping etc. to more painful means such as self-inflicted injuries, hanging etc. Hanging (53.6%), consumption of poison (25.8%), Drowning (5.2%) and fire/self-immolation (3.8%) were prominent means/mode of committing suicide. The incidence of hanging for committing suicide is increasing. This is a retrospective study carried out at KDN Gohil Hospital, Navsari (Gujarat) to know the outcome of this type of suicidal attempts and to review then management of this type of patients. This small study tries to compare mortality rate and management protocol with other larger studies.

Objectives: Objective of the study is to give details in to the pathophysiology of partial hanging and to discuss about management of such cases. The incidence of hanging is increasing and literature about its management is sparse, so this article makes an attempt to review the literature on this subject and the authors present their own study.

Methods: This study included all patients with a history of hanging or accidental strangulation who were brought to the hospital after being released from the strangulating agent. Various aspects of the agents used for hanging, as well as the patients' characteristic findings and management protocol, were studied retrospectively.

Results: The results were analyzed in terms of survival rate and occurrence of complications. Out of 44 patients, 37 survived and 7 died. There were no injuries to the cervical spine. One patient suffered a laryngeal injury that resulted in laryngeal stenosis.

Conclusion: Suicidal hanging is not the same as judicial hanging. If the patient is brought to the hospital alive, the suicidal hanging survival rate is usually high. The main management steps are early endotracheal intubation, hypotension management, ventilator support, and anti-edema medications.