Countywide council tackles protocol for what amounts to attempted murder.

By Elizabeth Pattman

The Victims Advocacy Council of Alamance is working to create a new countywide strangulation protocol to educate residents and first responders alike on the serious and sometimes long-term health effects of strangulation, and how to respond to these assaults.

According to Dr. LaTonya McIver Penny, executive director of Family Abuse Services, and Burlington Police Detective Kelle Sisk, a small group from the council is in the early stages of establishing this protocol, which is meant to guide victims, police, EMS and hospital staff on what to do if an individual reports being strangled.

“If a victim of abuse shows up at the hospital and says ‘I was choked,’ they would then tell them ‘No, you were strangled,’” Penny explained, noting that an individual chokes on a piece of food, but when another person causes the airway to be cut off, the proper terminology is strangulation.

“Then they have a protocol to follow. If they show up [at Family Abuse Services], we have something we follow, or if EMS shows up on the scene, or the police department, they have something to follow. There is a group of us coming from all of those agencies to create an Alamance Countywide protocol, which I’m very proud of,” Penny said.

“We’re still in the infantile stages of trying to figure out how to do this as a community, but we are trying to get some training and have some protocol go together so we’re all on the same page,” Sisk added.

In her role at Family Abuse Services, Penny said, many domestic violence victims report that their partners tried to choke them, which she said diminishes the severity of strangulation, which is what really happened.

“Most victims will say ‘He choked me,’ so we are very clear in our language. My staff will then say ’No, he didn’t. You choke on a piece of food. He strangled you. He literally took his hands, or any object, to cut your passage way of air off. He tried to stop you from breathing,” Penny said.

When we say it that way, most people say, ‘Oh, so he tried to kill me,’” she continued.

The council members who are working to create this strangulation protocol hope that it will guide first responders’ actions and educate the community at the same time.

“We’re trying to increase awareness on strangulation,” Penny said of Family Abuse Services’ role in this.

“We’re dealing more with strangulation, suffocation and asphyxiation. We need to try to get the details of that from people, so we’re trying to get a countywide protocol so that this is seen as more serious, taken more seriously, and to be able to educate our community about it,” Sisk echoed.

For first responders, this protocol would teach them what kinds of questions to ask and what health risks to be on the lookout for.

“That’s what can be so important with how the questions are asked and what is asked of this person, such as ‘Were you able to breathe? Did you pass out? Do you have a sore throat when swallowing? Are your ears ringing? Do you have any blurry vision?’” Sisk said.

For hospital staff, the protocol could help save lives as new research is showing that strangulation can have long-term and unexpected health risks.

“A strangulation that happened today, can impact you 15 years from now. You may have increased risk of a stroke, you may have an increased chance of dementia from a one-time strangulation, so were trying to give more information and research around that for the community to understand how serious it is,” Penny said.

Sisk compared strangulation to attempted murder to emphasize the severity of this type of assault.

“We’re learning now through a lot of training how serious strangulation really is. When you really think about it, you have someone in close quarters trying to cut your airway off. It’s basically attempted murder when you get right down to the nuts and bolts of it,” Sisk said.

In North Carolina, assault by strangulation is a class H felony.

“The reason this is all coming about is because of studies on cadavers. … They were finding on cadavers that the reason they were dying was because of strangulation, but [authorities] they didn’t know it until after death. So how do we figure that out, and how do we look more into that during the time of crisis?” Sisk said.

In an effort to cut down on extended health effects from strangulation, Moses Cone Hospital has introduced a strangulation kit to Cone Health hospitals in the area, including Alamance Regional Medical Center.

“What they are doing is the forensic nursing department, which does the sexual assault kits, is now being trained on strangulation and when to talk to folks about that,” Sisk explained. “They do a measurement of the neck, they’ll do some photographs. … They’ll do swabbing of the neck, they check the eyes and if they feel it’s necessary, they’ll do what’s called a CTA, which is like a CT scan of [the neck and throat] area to see if there is any tearing, or there is something that would need surgery inside.”

These strangulation kits are currently in use at ARMC, Sisk said, and are brought up when victims report being “choked” or strangled. The evidence is then given to the Police Department as needed for investigations.

Sisk explained that, unlike gunshot wounds or child abuse, strangulation is not currently mandatory for hospital staff to report to police under North Carolina law. Sisk said she’d like to see that changed.

“Strangulation, right now, is not a mandatory report to police. … If it is not life-threatening, like immediately life-threatening, we are not called,” she said. “There would actually have to be changes. We would have to go up to Congress to make that happen.”

In addition to helping first responders and medical professionals respond to strangulation cases, Sisk said she also hopes this protocol will help victims and people in the community understand how serious it is.

“If this is something they’re experiencing, they need to understand the potential life-threatening things that go along with it,” she said.

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