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J Korean Soc Emerg Med > Volume 7(3); 1996 > Article
Journal of The Korean Society of Emergency Medicine 1996;7(3): 384-389.
CLINICAL ANALYSIS OF HANGING
Seong Youn Hwang, Keun Lee, Cheol Wan Park, Sung Man Bae, Chang Hae Pyo, Hyeng Soo Kim
Department of Emergency Medicine, Chung Ang Gil Hospital, Inchon, Korea
  Published online: September 30, 1996.
ABSTRACT
We reviewed retrospectively 16 hanging patients who visited the emergency department of Chung Ang Gil Hospital between January 1992 and December 1995. The results were as follows: 1. The male to female ratio was 11:5(2.2:1). 2. The age distribution was from the second to ninth decades and the peak incidence was between 20 and 39(50%). 3. The cause of hanging most likely was suicidal in all cases. 4. The tools of ligature selected by victims were rope(10), cloth(3), wire(2) and flex(1). 5. Of the type of suspension, ratio of complete type to incomplete was 3:13. 6. Eight cases had underlying diseases, which was cerebro-vascular disease(3), depression(2), cancer(2) and poliomyelitis(1). 7. The duration of suspension was poorly documented on charts in most cases and the transport time of victims from the scene to emergency department ranged between 10 minutes to 2 hours. 8. Petechial hemorrhages were seen in 1 case of incomplete suspension, and congestion of the face was seen in 1 case of complete suspension and 8 cases of incomplete suspension. 9. Rigor mortis was seen in 1 case of complete suspension and Tarclieu's spot was seen in 1 case of incomplete suspension. 10. Cervical spine x-ray and brain CT scan were checked for only 4 cases of incomplete suspension and were normal. 11. Glasgow Coma Scale(GCS) levels on arrival was 3 in 13 cases; 6 in 2 cases; 7 in 1 case. 3 cases with GCS≥4 survived to discharge without neuropsychiatric sequelae and 12 cases with GCS=3 required cardiopulmonary resuscitation(CPR), of which 1 case had return of spontaneous circula­tion(ROSC) but died in hospital after 1 month, but the others were not resuscitated. 12. We suggest that aggressive CPR and advanced life support is indicated even in patients without evident neurologic function, if evident signs of death(i.e., rigor mortis, livor mortis, algor mortis, desiccation, putrefaction etc.) are not seen.
Key words: Hanging; suspension; Glasgow Coma Scale; cardiopulmonarv resuscitation
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