Sunday, February 10, 2013

Strangulation Part Two: More on Mechanisms

A couple of questions: when you set a scene where someone is being choked by an object around the neck or pushing against the neck - that death isn't immediately from that particular action, but rather it is the breaking of the hyoid and the swelling that results from it? So unless the garotte cuts through to the carotid arteries, this could be a much slower way to die?

What about people who go unconscious from lack of air? Is it possible they could also suffer from the hyoid breaking and not wake up after passing out? I'm just curious as to how alive a person might be in order to overhear his would-be killer's plan :)

Thanks ~ Killion
Hello, Killion!
The brain needs blood. A few seconds without blood flow causes unconsciousness. This is the so-called simple faint. You lay the victim down, more blood flows to the brain, and the victim wakes up.

After a couple of minutes--like in a cardiac arrest situation--the brain is starving for oxygen, and the cells can be damaged. Waking up is harder, takes longer, and the victim may have deficits.

Four to five minutes--and brain damage (enough to cause a vegetative state, as in organ donor) starts.

All of this just from lack of blood flow through the carotid arteries.

The initial stage of "strangling" is the result of the victim passing out from lack of blood flow. They're defenseless.

The perpetrator continues squeezing the neck.
Breaking the hyoid usually collapses the airway. There is immediate soft tissue damage and swelling. Now you have impaired blood flow to the brain and impaired oxygen in the bloodstream.

Lack of air alone won't break the hyoid. Strong hands--usually a man's hands--with thumbs over the hyoid is necessary to break it.

Passing out from lack of air--like at altitude (a small plane for example, or suffocating inside a plastic bag) is because of low oxygen. Defenseless victim.

If the bad guy strangled the victim just enough to cause a faint (there would still be a pulse and breathing) the victim could potentially wake up and overhear the plans.

Since the brain prefers glucose (sugar) as its food source, low blood sugar will cause passing out (example--a diabetic who takes their insulin then doesn't eat).

Hope this helps clarify the situation.
Cheers, Kelly

Questions? Comments?
Kelly has worked in the medical field for over twenty years, mainly at large medical centers. With experience in a variety of settings, chances are Kelly may have seen it.

Sometimes truth seems stranger than fiction in medicine, but accurate medicine in fiction is fabulous.
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  1. Great post and so informative. I always learn a lot here.

    1. Thanks, Marian! Me too. Always good to have a rigorous review of the subject matter.