Although the terms are often used interchangeably, choking and strangulation are not the same thing.
Choking is an accidental, internal event that occurs when an object, such as food or a small item, lodges in the throat or windpipe, preventing air from entering the lungs.
Choking can cause breathing difficulty, coughing, gagging and panic as the body tries to clear the obstruction.
Strangulation is external pressure deliberately applied to the neck, restricting airflow and/or blood flow to the brain. This can be done using hands, other body parts or objects such as belts, cords or scarves.
Strangulation can cause serious physical and psychological harm, even without visible injuries. Symptoms range from gasping and hoarseness to loss of consciousness and seizures.
Whether strangulation occurs during an assault, an incident of intimate partner violence, sexual activity or another situation, it can become life-threatening very quickly.
Please seek medical care immediately if you experience:
Some complications, including swelling, facial weakness or signs of stroke, may not appear right away. If you notice new or worsening symptoms in the hours or days following a strangulation, seek medical care even if you initially felt well.
A range of medical and support services are available after a strangulation. At Carroll Hospital, Emergency Department (ED) providers and Forensic Nurse Examiners work together to provide care tailored to your symptoms, concerns and personal preferences.
Emergency Department Care
In the Emergency Department, your care team’s first priority will be evaluating and treating any injuries or medical concerns.
This preliminary evaluation may include:
If you have severe or lingering symptoms, such as weakness, dizziness or concerning bruising, additional testing may be recommended. This may include a CT angiogram (CTA) to check for injury to the blood vessels in the head and neck.
If you have concerns about intimate partner or domestic violence, ED staff may complete a Lethality Assessment Program (LAP) screening and connect you with hospital-based or community resources.
Forensic Care Center Evaluation
At your request, a specially trained Forensic Nurse Examiner may perform a detailed head-to-toe examination with special attention given to the head, eyes, ears, mouth and neck.
The nurse examiner will discuss your recollection of what happened, assess for injuries and document any findings.
This evaluation may include:
Before you leave, we will make sure you have appropriate resources and follow-up care information.
If requested by the State's Attorney's Office, members of our team may also provide fact and expert witness testimony in court.
Immediate responses to choking often involve back blows or the Heimlich maneuver, which uses abdominal thrusts to help dislodge the obstruction and restore airflow.
If the person becomes unresponsive or is unable to breathe, call 911 immediately.
Strangulation is generally categorized into three types:
Sexual "choking," also known as breath play, is a form of strangulation that occurs during sexual activity.
Some people engage in self-strangulation, a behavior known as autoerotic asphyxiation.
Yes, sexual choking carries many of the same risks as any other form of strangulation.
Even when there is no intent to cause harm, pressure applied to the neck can lead to serious injury, including brain injury, stroke, loss of consciousness and death.
As oxygen levels fall or consciousness changes, a person may no longer be able to communicate, withdraw consent or ask for help.
The Choking Game is a dangerous activity in which children and teenagers intentionally reduce oxygen and blood flow to the brain to create a brief feeling of euphoria or a "high."
Other names for the Choking Game include:
You can learn more about who is participating, why you should be concerned and how you can protect the kids in your life at the Training Institute on Strangulation Prevention.
Warning signs may include:
Parents and caregivers can help by encouraging open communication, discussing the risks of oxygen deprivation and speaking with a medical professional if concerns arise.
