Legally, Strangulation is the knowing or intentional impediment of breath or breathing. It's one of the common forms of domestic battery, and a victim who is choked or strangled is 80% more likely to die of a homicide in an intimate partner violence situation later. Strangling someone is about power and control.

50% of strangulations have no visible injuries - most injuries are internal. Only 3% of victims seek medical attention afterwards, since they believe that they're now breathing again, there is no damage. If someone says they are choked or strangled, we should willingly send EMS to have them evaluated, and whatever unit(s) on scene should advise that they follow up with a doctor ASAP to get an MRI. The best way to detect strangulation injuries is on autopsy, but that's not ideal for obvious reasons.

Many strangulations can lead to serious complications and death later. For example, if there is a damage to the carotid artery, the blood clot that the body forms to address it is very likely to go up to the brain and cause a stroke. Repeated strangulations can cause irreversible brain damage, and it is difficult for the body to get back together after each one (32,000 neurons and 230 million synapses die per second of oxygen deprivation. And those guys do not grow back).

The Strangling Itself:
It takes 11lbs of pressure to cut off the carotid artery. I personally can apply 7 times that with one hand and 11 times with both hands; one can probably even do more. It takes 4lbs of pressure to occlude the jugular and 34lbs to occlude the trachea.

A chokehold applies 160lbs of pressure, chokeholds are considered lethal force for law enforcement and they're no longer taught in most jurisdictions. A chokehold is sometimes more effective than a gunshot. Even if someone fights a chokehold, they get weaker with each second of oxygen deprivation and repeated choking and releasing of a person will get them to a point that they will lose consciousness and eventually succumb to a brain damage.

TIMELINE OF STRANGULATION
6.8 seconds - unconsciousness
8-10 seconds - Possible clonic seizure due to anoxia
15 seconds - Loss of Bladder control
15-20 seconds - Petechial Haemorrhage/Venal rupture
30 seconds - Loss of bowel control
1-2.5 minutes - Death

The muscles can be bruised without a visible surface injury (particularly in the case of chokeholds. The pressure of the arm is spread over a wide area and is less likely to bruise on the skin. Manual strangulation which is the most common form can leave no marks. Ligature strangulation leaves the most obvious signs), so it is always advisable to take photos at the initial response, also to take photos of inside the eyelids to capture the Petechial Haemorrhages as well as the soft palate of inside the mouth. The haemorrhage can cover the entire neck and head even down to the abdomen and chest in the case of pressure/weight applied to the chest to impede breathing and back up the veins under the skin. It is generally pronounced in the soft tissues.

Long term damages include: Larygneal edema, tracheal tearing, carotid tears, seizures, cryogenic stroke, brain damage, encephalopathy and miscarriages. There can also be symptoms similar to TBI's such as behavioural changes and the incident can easily result in PTSD.

There will be memory loss after a person is strangled, since the brain cannot form memories while deprived of oxygen and the trauma of the situation can cause the primal/instinctive hindbrain to take over. It can be difficult to question a person who has just been through this due to physical and psychological effects, so it's best to ask them to describe sensations rather than perceptions.

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