Curbing domestic violence by recognizing signs of strangulation

Crime Survivors inc. Founder and CEO Patricia Wenskunas speaks to a group of about 150 attendees at the Domestic Violence Summit held at College of the Canyons in Valencia on Friday. Dan Watson / For The Signal

The more first responders know about strangulation, the more effective they’ll be in putting abusers behind bars, saving victims and curbing domestic violence.

Speaking at the Domestic Violence Summit at College of the Canyons Friday, professionals who work daily with victims of domestic violence shared what they’ve learned about strangulation – how easy it is to commit for the perpetrator, how lethal it is for the victim, how easy it is for police to miss and how hard it is for prosecutors to prove.

Then the professionals offered ways of correcting these shortcomings and outlined efforts underway to help in the arrest and conviction of strangling perpetrators.

Those attending the Summit session dubbed – Strangulation: among the most lethal forms of domestic violence – learned how easy it is to kill someone through strangulation.

It takes just 11 pounds of pressure to stop the carotid (neck) artery sending oxygen to the brain, according to the panelists.  A normal man’s handshake, by comparison, involves about 80 pounds of pressure per square inch.

Opening a can of soda requires about 20 psi.

Medical responders

Gina D’Aquilla, a Sexual Assault Nurse Examiner, showed session participants what physical signs to look for in examining a strangulation victim.

This was important, she said, because “some people don’t have any signs of injury from strangulation at all.”

Telltale signs of strangulation are elusive, subtle and easily overlooked.  One sign to look for, she said, is evidence of burst blood vessels in the victim’s eyes.

Flashing photos of actual strangulation victims during her presentation, D’Aquilla was able to show participants – many of whom were domestic violence counselors – what to look for in cases where strangulation is suspected.

For example, between 40 and 45 percent of strangulation victims urinate during the attack as a result of having experienced a sudden loss of bladder control.

Knowing about this common consequence of strangulation would prove helpful for first responders who interview victims claiming to have been strangled.

Police responders

Ventura Police Department Detective Ed McCain who also spoke at Friday’s Signal-sponsored summit said he trains young officers on ways to identify strangulation as part of Ventura County’s recently updated domestic violence protocol.

“It used to be, we would respond to reports of strangulation, see no visible signs of injury and then tell the victim ‘See you later.’

Now, he trains officers to recognize elusive strangulation symptoms.  The training is an emerging protocol gradually working its way into regular law enforcement training.

McCain pointed out that all too often “police reports neglect to clearly document strangulation symptoms.”

To that end, in an effort to close that procedural loophole and strengthen police reports, Ventura County Supervising Deputy District Attorney Audry Nafziger came up with a strangulation checklist for law enforcement officers responding to domestic violence calls.


She compiled a checklist of strangulation evidence, she said “after reviewing several rejected cases involving women who said they were being choked.”

“We were not properly handling these cases,” she said. “Because we didn’t have evidence. So we decided to do something about it.  And, now, we are starting to turn it around.”

Because strangulation is an easy and effective way of exerting power and control over the victim, panelists

pointed out repeatedly during the 75-minute session Friday that abusers who strangle are sending a message that says: I am a killer.

“A non-fatal strangulation is highly associated with future liability,” Nafziger said. “He (abuser) has declared himself as a killer.”

A strangulation victim, she said, is seven times more likely to be murdered by her abuser – not necessarily killed by strangulation, but murdered just the same.

As well, about half the law enforcement officers killed in the line of duty are killed by men who have a prior documented history of strangulation.

Since strangulation evidence is difficult to find and gather, one of the tools Nafziger hopes to standardize is the regular use of medical tests called “CT Angio” tests.

It’s the only test that shows occlusion of the blood vessels of the neck by external pressure, she said, which is the long way of describing strangulation.

CT Angio tests – or computed tomography angiograms – are an enhanced way of seeing the arterial and venous vessels – arteries and veins – throughout the body with the help of high tech equipment.

The test ranges from arteries serving the brain to those bringing blood to the lungs, kidneys, arms and legs.

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