Page 101 - CFDI Guide

Additional assessment findings may include the decedent’s face being purple, congested and possibly

swelling above the point of the ligature. Their the tongue may be protruding and dark from exposure,
possible bloody mucus from the nose and/or mouth, and possible scratches at the ligature.

In suspected homicides – or physical assaults – the assessment of a suspect is important, depending on the

time elapsed – and activities (i.e. showers) since the incident. The victim may have injuries from a
struggling victim, mutual combat, or self-defense. A reported aggressor may have injuries from a struggling

victim, mutual combat, or their own self-defense. It is possible, and should not be ignored, a victim may
have been the initial aggressor and the act of strangulation may have been by a person acting in self-

defense of themselves or another person. Additional assessment details in conjunction with the scene
investigation are below.

At scene and autopsy, and in physical examination for surviving persons, indications of manual

strangulation – such as hand impressions, should be looked for. Persons questioned as suspects may
verbalize their arms and hand muscles aching, or rubbing them, which may be a sign of adrenaline exertion

during the act of choking. Additional examination and assessment should note any evidence of acute
injuries – and absence of the same. Indications of chronic, and healing injuries, showing previous activity

are also important. Evidence of contusions, lacerations or other traumatic injuries to the head, face, ears,
nose, lips (including tongue, frenulums, and dentition). Also the arms and hands, legs and feet – including

nails and nail beds. The genitalia and buttocks should also be examined. At autopsy the neck muscles are

examined for evidence of inflicted trauma to the thyroid cartilage and hyoid bone, or the esophagus and
trachea structures. A person manually choked and then hanged may show evidence of the manual
choking.

Scene Description
Specific to asphyxiations, the scene may include a means, instruments, and other evidence direct to the

act and circumstantial – such as a struggle. To fully understand the dynamics of an incident involving
asphyxiation, the CFDI need not know medical specifics, and should have a working knowledge, as

presented in this program. Knowing how the scene was assessed, and the means of asphyxiation gives
CFDI methods to determine if there are issues to the law enforcement investigation, as well as statements

of involved persons.

Hanging: ligature restricting arterial blood to the brain or venous blood from the brain. Loss of
consciousness occurs rapidly, creating neck tension from added unconscious weight. The ligature need

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