Question and Answer: What Happens When Someone Is Hanged? | The Crime Fiction Writer's Blog
I have a pound man of slight build who has been hanged. Since the asphyxia is due to compression of the arteries and not the prevention .. him him to do that i mean when he was the nicest person you could ever meet. in the head and neck by the obstruction of the veins that drain those areas. The central retinal vein and artery line the back of the retinal wall. Healthy veins and arteries should appear consistent in width, with a deep red. Peripheral artery disease (PAD) occurs when plaque clogs the arteries in When you exercise, your blood flow may not meet your body's need for extra oxygen. leg pain during the night or during rest that goes away if you hang your leg.
What else would we see? If unconscious, would he revive quickly? Could his injuries be life-threatening? No ER or modern medicine. In hangings, death results from asphyxia, which is the reduction of oxygen to the brain. Asphyxia in hangings results from the compression of the airways and the carotid arteries the arteries on either side of the neck that carry blood to the brain by a noose or other ligature that is pulled tight by the body weight. Thus, the victim must be completely or partially suspended.
Though the airway can be compressed and breathing can be interrupted, the real cause of loss of consciousness and death in most hangings is compression of the carotid arteries, which blocks blood flow to the brain.
Except for judicial legally directed hangings, fractures of the cervical vertebrae spinal bones of the neck are uncommon.
The reason is that these fractures require that the body drop a sufficient distance to break them. How far is this? The answer depends upon several factors. Individuals who are obese, have small neck musculature, or who have arthritis of the cervical spine may suffer neck fractures quite easily.
Just the opposite is true for muscular, thick-necked persons. In judicial hangings, these factors are considered in gauging the distance of the drop. Too little drop and the condemned person is strangled to death, too far and he could be decapitated. The neck markings seen after hanging depends mainly on the nature of the noose used.
Soft nooses such as sheets may leave little of no markings. Bruises and abrasions are not common with softer devices. In fact, if the victim uses a soft noose and if the body is discovered fairly quickly and cut down, the ME may not be able to find any marks at all. The longer the body hangs, the deeper the furrow. Blood clots can occur in the veins which return blood to your heart and lungs. They have the regular thrombus that form on sites of injury, such as from a contusion.
The large varicosities where flow is slow are easily bruised. Blood clots can form in areas of chronic low flow because of being in a sitting position too long. Flow in the normal veins, which are much larger in diameter than the arteries, is already much slower. Veins tend to hold blood longer and flow is never fast moving.
Inherited or genetic clotting abnormalities cause much more trouble in veins than in arteries because of the fact they are more inclined to clot.
If you have a family member with a history of forming blood clots, please read more below inherited thrombophilia. If you have an acquired thrombophilia, you are more sensitive to clotting abnormalities that go with autoimmune diseases such as rheumatoid arthritis, lupus anticoagulant and antiphospholipid syndrome or ulcerative colitis.
Veins are also more sensitive to changes in coagulation with birth control pills, hormones and pregnancy.
When vessels are relaxed and dilated late in pregnancy due to higher hormone levels, they are also more prone to clot. If one is immobile for any period of time, whether it be after surgery, riding long distance in a car or flying long distance in an airplane, or if you are paralyzed, you have a cast on your leg, your ankle joints become frozen and do not work or anything that prevents you from using your feet and ankles normally and ambulating normally leaves you at increased likelihood to clot.
Being grossly overweight impedes some of the blood flow return again further slowing blood flow from your legs. Sitting with your legs hanging down or horizontal 90 degrees to your body on a footstool all decrease velocity of return toward your heart.
Also anytime you are very ill and dehydrated, you have a decreased cardiac output either from a heart attack, sepsis or other problems, you are more likely to develop clots in your veins. Superficial vein thrombosis and deep vein thrombosis. Superficial vein thrombosis means veins under the skin such as your great saphenous vein, small saphenous vein and the large tributary veins from any of these.
All the factors we have mentioned can cause them to be susceptible to thrombophlebitis blood clots in your veins.
Meet the heart!
Cancers trigger clotting mechanisms cause hypercoagulability until they are under control or in remission thus requiring long periods of anticoagulation. This stagnant blood begins to form small clots along the walls of the vein.Know The Differences- 5. Artery, Vein and Capillary
This initial clot can gradually grow to partially or completely occlude or block the vein and prevent blood from returning to the heart. An analogy to this process is a slow moving river where, over time, weeds and algae start to accumulate along the banks of the river where the water flows more slowly.
Gradually, as the weeds start to grow, they begin to invade the center of the river because they can withstand the pressure of the oncoming water flow. If your deep veins have had a thrombophlebitis or clots in the past, they may be scarred shut leaving you with impaired outflow to your legs thus leaving you more susceptible to your next blood clot.
Embolization from veins is totally different than in your arteries. Embolization from veins usually occurs from the veins in the pelvis, thighs, groin or from the knee level. When these clots break loose they go through the heart into the lungs blocking off blood flow and this pulmonary embolism PE can cause death with the first event though some will shower smaller clots over a period of time.
The warning sign of smaller clots is a sudden feeling of impending doom, shortness of breath or pain in your chest when you breathe in and out pleuritic. If you have any symptoms, your physician needs to know immediately and not two days later. What are symptoms of blood clots in the legs or arms? Venous clots do not allow blood to return to the heart and symptoms occur because of this damming effect. Most often occurring in the legs or the arms, symptoms include: Swelling Redness Pain Venous blood clots often develop slowly with a gradual onset of swelling, pain, and discoloration and symptoms will often progress over hours.
Deep vein thrombosis symptoms are not always obvious. The classic signs of a blood clot are swollen and tender calf or calves. Unfortunately, these classic signs are not always present and you should be aware of other possible symptoms of DVT that include: Red areas on the leg Swelling in one area or on one leg Pain or tenderness in one leg Temperature differences between the two legs a leg with a clot may be warmer to the touch Since not everyone with DVT experiences the above symptoms, you should be aware of the signs and symptoms of a pulmonary embolism, which can occur as the result of a blood clot.
Because pulmonary embolisms are blood clots in the lungs, the signs will be related to your breathing. Shortness of breath Feeling of impending doom Sharp pain described as stabbing, burning, aching, dull and heavy under your breastbone or to the side of your chest Increase in pain when you take a deep breath, cough, bend, or stoop Increase in breathing rate Sudden cough Coughing up blood or blood-streaked sputum phlegm or mucus Certain types of blood clots, called superficial thrombophlebitis, have symptoms similar to those of DVT but are typically less serious.
One way to tell the difference is that with superficial thrombophlebitis the redness and warmth is located along a vein just beneath the skin and you can feel the tenderness and a ropey feeling. How are they diagnosed? When your family physician is suspicious of a clot in your veins, a referral will most frequently be made to a vascular specialist or diagnostic radiologist.
Venous blood clots may be detected in a variety of ways. Venous ultrasound venous duplex Doppler is the most widely used method for evaluating suspected DVT. This is a safe, non-invasive test and more detailed information can be read by clicking here.
CT venography is a radiographic technique that uses a computer to assimilate multiple X-ray images into a two-dimensional cross-sectional image. Veins are not normally visible on an X-ray image, so a special dye is injected into your blood to make them stand out.
In the past venography a catheter was placed in your vein was considered to be the "gold standard" test for diagnosing and investigating vein disease. However, today venography has mostly been replaced by duplex ultrasound to examine the health of the veins and look for blood clots Magnetic resonance imaging MRI employs a powerful magnetic field to generate a high-resolution image of anatomic structures.
This non-invasive study may be used to diagnose DVT. Blood testing can also be used to screen for blood clots. D-dimer is a breakdown product of a blood clot, and its levels in the bloodstream may be measured. Blood clots are not stagnant; the body tries to dissolve them at the same time as new clot is being formed. D-dimer is not specific for a blood clot in a given area. What is the treatment?
Treatment is most often individualized for each patient depending upon the clinical situation and other medical conditions that may be present.
Clots in the superficial system are often treated symptomatically with warm compresses and NSAIDS ibuprofen, Motrin, Aleve since there is usually no risk for clots in the superficial veins to embolize to the lung. Superficial veins are connected to the deep system by perforator veins. If a clot is in the superficial vein near a perforating vein, it may propagate through the perforating vein into your calf or thigh and become a DVT. A clot in a superficial vein can propagate up the great saphenous vein to the saphenofemoral junction and into the common femoral vein.
A clot can propagate up the small saphenous vein into the popliteal vein and become a DVT. If a clot is propagating into a perforating vein, in the great saphenous vein within 8 cm of the saphenofemoral junction or nearly into the popliteal vein, these are no longer treated as a superficial system blood clot. DVT usually requires anticoagulation to prevent the clot from growing and causing a pulmonary embolus.
Most cases of DVT can be successfully treated with a combination of medications, including heparin or Lovenox and then Coumadin warfarin or possibly one of the newer drugs such as or similar to Pradaxa. Once these medications are started, most people take them for 3 to 6 months or longer one year if there is a pulmonary embolus and must see their doctor regularly for monitoring.
You will also have periodic duplex venous Doppler studies. The treatments will be individualized. In more severe cases, or when other health conditions keep people from being able to take these medications, alternative interventions inferior vena cava filter and surgeries are possible. Blood clots below the knee are at lower risk for embolization to the lung. All clots once they are found and treatment initiated should be re-evaluated with venous duplex Doppler in 2 to 14 days to monitor the clot to see if it is growing or propagating.
Peripheral Artery Disease (PAD)
Clots in the femoral and common femoral vein should be restudied to be sure they are not propagating in the veins in the pelvis. PE are treated similarly to deep venous thrombosis but more emergently and aggressively.
Admission to the hospital for treatment and observation is mandatory. You are given IV anticoagulant with some form of heparin such as Lovenox and then started on long-term anticoagulation with warfarin Coumadin or one of the newer anticoagulants. If you have had a pulmonary embolus, you will be on anticoagulation for six months to a year at least.
Your blood thinner will be checked frequently to be sure the levels are adequate. If lung function is compromised and the patient is short of breath or is experiencing hypoxia, or low oxygen levels, or has heart enzyme changes, a clot buster may be used to decrease the size of the clot in the lung. Surgery may be required to get the clot out of your chest, but you do not want to wait until you are in this kind of shape before seeking medical attention.
You may also need a filter placed in your inferior vena cava because the second blood clot on top of this problem could again be life-threatening. Routinely thrombolysis of clot in the common femoral vein at the groin, iliac vein up to the inferior vena cava and some into the inferior vena cava is relatively standard providing you meet certain criteria.
Circulatory System Review Guide
If you have had a recent stroke or recent surgery, or other health problems, you may not meet criteria. Many times prior to doing this an inferior vena cava filter is placed to prevent large clots from breaking loose and going to your lungs. Thrombolysis of clot from your groin to your knee is so far not recommended. An iliofemoral vein thrombosis that does not resolve is a life-changing event. Blood that goes into the leg in an artery must come back out of the leg.
You normally flow to cc per minute into the leg through the femoral artery in your groin. Your leg will become tight, swollen and painful and you will have to stop and rest until the blood slowly drains out of your leg.
With a walking exercise program, you can develop some new collateral veins, but they are never as good as the first ones. A progressive walking exercise program is a very important part of your rehabilitation. Occasionally the iliac veins have to be dilated and stented and again you will be on long-term anticoagulation of six months to a year at least.
Sometimes a thrombosed iliac vein can be dilated and stented if it is less than 3 to 6 months old. The age of the thrombus does not always correlate with age in days and weeks.
Although surgery is rarely recommended as a treatment for DVT, venous thrombectomy is an option but is not without controversy as many times the patient will form new clots and, therefore, is on anticoagulation therapy afterwards. On rare instance the clotting is so extensive in the leg that the venous pressures become so high that they block off arterial flow to the leg causing loss of the extremity.
If this is approaching, the clot will be removed in one form or another and may require opening the skin in the fibrous compartment over the muscles of the lower leg to prevent them from dying.