STRANGULATION AND/OR SMOTHERING
As per Attorney General Law Enforcement Directive 2023-03, BREATHE Team (Breathing/Blood flow Restriction Event: Advocacy, Treatment, Help, and Empowerment) services shall be available to anyone who experiences nonfatal strangulation and/or smothering.
What is Strangulation and Smothering? Strangulation/smothering is defined as pressure on the throat or neck or blocking of the nose or mouth, thereby obstructing the breathing and/or blood circulation of the victim and causing reduced oxygen and blood flow to the brain. These incidents are classified as strangulation, commonly referred to as “choking”.
BREATHE Team Members: The BREATHE Team is comprised of a Forensic Nurse Examiner (FNE), a confidential victim advocate and law enforcement. Upon reporting a strangulation and/or smothering assault, victims shall be advised of their right to accept all, or any portion of, BREATHE Team services as soon as possible.
BREATHE Activation Criteria: The BREATHE Team can respond to any reported cases of strangulation and/or smothering which meets the following criteria:
1. The victim describes being strangled and/or smothered;
2. The victim consents to the medical forensic examination and is willing to be seen at a hospital Emergency Department; and
3. The incident occurred within the past five (5) days and/or if the victim exhibits continued visible signs or symptoms of strangulation or smothering injury.
Although the Attorney General’s Directive is focused on offenses of strangulation and/or smothering against a person who meets the definition of a victim of domestic violence, anyone who survives a strangulation and/or smothering assault will be afforded access to BREATHE Team services, including a medical forensic examination performed by a qualified FNE.
Each county has their own mechanism to activate the BREATHE Team. In most cases, to utilize the services of the BREATHE Team you would go to your local emergency department or law enforcement agency within 5 days of the incident and/or if you exhibit continued signs or symptoms of strangulation and/or smothering.
IMPORTANT MEDICAL NOTICE:
If you have experienced a strangulation and/or smothering incident it is vital that you seek medical attention. Even if you feel fine right now, strangulation can cause internal injuries, brain damage, and delayed health consequences, such as strokes, thyroid issues, miscarriage, or even death. These effects can occur days or weeks after the incident, sometimes without any visible signs of injury.
You are strongly encouraged to seek immediate medical attention at an emergency department. If you are unable to do so, please make an appointment to see your physician as soon as possible.
*If you are pregnant and experiencing any of the following, report to an emergency department immediately:
- Decreased movement of the baby
- Vaginal spotting or bleeding
- Abdominal pain
- Contractions
Even if you are not experiencing the symptoms above, it is important to talk to your doctor about the incident right away.
BREATHE Team Exam Advisement - The Forensic Nurse exam itself is free, there will be no cost to you for that exam. You will be responsible for the hospital bill and any tests or procedures that are performed as a result of your visit to the emergency department. If you do not have health insurance, there are victim services available that may be able to help you pay those medical bills.
FACTS on Strangulation
- Many victims of strangulation exhibit no visible signs of injuries, but because of the trauma inflicted, may sustain life-threatening internal injuries, including traumatic brain injury, damage to carotid arteries, stroke, and/or permanent visual impairment.1
- Only half (50%) of strangulation victims have visible injuries. Of these, only 15% could be photographed while the remaining 35% have injuries too minor to photograph.2
- The risk of homicide was found to be approximately 750% higher for domestic violence victims who had experienced strangulation previously with their intimate partner.3
- Strangulation is among the most lethal forms of Domestic Violence. Loss of consciousness can occur within 5-10 seconds. Death within minutes.4
If you would like more information on requesting a Restraining Order, please access the following link to NJ Courts which explains the process. Domestic Violence | NJ Courts
For more information and resources on strangulation, please access the link below to the Training Institute on Strangulation Prevention. Survivor Resources (strangulationtraininginstitute.com)
1 Gael B. Strack et al., Investigating Strangulation Cases, in THE INVESTIGATION AND PROSECUTION OF STRANGULATION CASES, supra note 2, at 57.
2 2 Campbell, et al, (2018) The Effects of IPV and Probable Traumatic Brain Injury on Central Nervous System, Journal of Women’s Health, 27 (6); Zieman, et al (2017). Traumatic Brain Injury in Domestic Violence Victims: A Retrospective Study at the Barrow Neurological Institute. Journal of Neurotrauma, 876-880.
3 Glass, et al (2008). Non-fatal strangulation is an important risk factor for homicide of women. The Journal of Emergency Medicine, 35(3), 329-335.
4 Patch, et al (2022). Emergency Evaluation of Nonfatal Strangulation Patients: A Commentary on Controversy and Care Priorities. Journal of Emergency Nursing, 48(3), 243-247.
