Non-fatal strangulation: a guide for GPs

19 Sep 2019

A role for GPs in the identification and management of non-fatal strangulation has been highlighted in the latest issue of MJA InSight.  

Non-fatal strangulation often leaves no obvious signs of injury, and is therefore commonly underreported. However, non-fatal strangulation has been linked to serious neurological and physical symptoms that can occur immediately, or be delayed up to weeks after the incident. Survivors of strangulation report experiencing ongoing emotional and psychological trauma, and research has shown a history of strangulation by an intimate partner significantly increases the odds of becoming an attempted homicide-, or homicide victim.

Women experiencing family and domestic violence are likely to turn to GPs more often than any other professional group. While there are resources available to assist GPs in identifying and working with patients experiencing violence, GPs report multiple barriers to recognising and engaging patients in discussions about family violence, including inadequate training, a lack of confidence in raising the issue, time restrictions and a lack of uniform screening assessments to determine whether violence is occurring.

The authors outline several actions that GPs can take to assess the occurrence and impact of non-fatal strangulation when a patient has disclosed or are suspected victims of domestic and family violence. They suggest that women should be specifically asked about whether they have had pressure applied to their neck in any way, and to take note of any neurological symptoms, including strokes, seizures and vascular abnormalities that may indicate internal injuries from a recent strangulation. It is advised to also determine the time since strangulation, and how the strangulation occurred. Noting symptoms that occurred during or since strangulation (e.g. headache, memory loss, unexplained urination or defecation) is advised to inform the clinical assessment and referral pathway. Finally, GPs should be aware of local family and domestic violence services available to provide ongoing support for psychological and emotional symptoms as well as safely and legal concerns.

Read the full article here.

The AMA’s own Supporting Patients Experiencing Family Violence: A Resource for Medical Practitioners is available at