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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

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