Va. nonprofit offers training to recognize signs of strangulation

The free training seeks to teach first responders proper screening for potential cases of domestic violence


Adele Uphaus–Conner
The Free Lance-Star, Fredericksburg, Va.

STAFFORD COUNTY, Va. — Strangulation is one of the most serious and potentially lethal assaults that can be committed in the context of domestic violence, yet it often goes unrecognized.

“What we know is how few signs there are, unless someone inquires,” said Kathy Anderson, executive director of Empowerhouse, the local nonprofit supporting survivors of domestic violence. “You have to ask specific questions.”

Empowerhouse, a Virginia nonprofit that supports survivors of domestic violence, will hold a free training to teach first responders and medical professionals how to spot the signs of strangulation in domestic violence cases. (Photo/Empowerhouse Facebook)
Empowerhouse, a Virginia nonprofit that supports survivors of domestic violence, will hold a free training to teach first responders and medical professionals how to spot the signs of strangulation in domestic violence cases. (Photo/Empowerhouse Facebook)

Hoping to help domestic violence and sexual assault professionals save lives and improve their response to strangulation crimes, Empowerhouse—along with Mary Washington Healthcare, the Stafford County Sheriff’s Office, Stafford Commonwealth’s Attorney and the Stafford Victim Witness Assistance Program—will provide training on “Identifying, Treating, Investigating and Prosecuting Domestic Violence Strangulation Cases.”

Emergency room doctors and nurses, sheriff’s deputies, first responders, prosecutors and advocates in the Fredericksburg area have been invited to the free training, which will be offered from 8 a.m. to 5 p.m. March 3 and 4 at the Fredericksburg Expo Center.

It will be led by lawyer Gael Strack, an internationally recognized expert in non-fatal strangulation cases and a co-founder of the Alliance for HOPE International—the organization that oversees the Training Institute on Strangulation Prevention, which is providing the curriculum for the training.

Bill Green, the medical director of the California Clinical Forensic Medical Training Center and developer of sexual assault forensic examination protocols used nationwide, will discuss strangulation from the medical perspective.

The training is funded through a grant Empowerhouse and the Stafford Sheriff’s Office obtained from the U.S. Justice Department’s Office of Violence Against Women of Justice in 2018. The grant also funded a full-time civilian domestic violence and child advocate at the Stafford Sheriff’s Office.

According to Training Institute on Strangulation Prevention, one in four women will experience intimate partner violence and of those, 68% will experience near-fatal strangulation by their partner.

In a strangulation event, loss of consciousness can occur within five to 10 seconds. Death can occur within minutes—or up to three weeks after the event, said Susan Sigmond, an Empowerhouse court advocate.

“It does tend to be a gender-biased crime, man-on-woman perpetrated,” said Sigmond.

Seventy percent of women who are strangled believe they are going to die and 38% lose consciousness. Yet only half of victims have visible injuries and only 15% of these visible injuries can be photographed.

“No visible injuries does not mean no injuries are present,” Sigmond said.

Loss of consciousness from strangulation can make it hard for those who survive the attack to understand what happened to them.

“[A survivor] may not be able to say what happened to them ...,” Anderson said. “And even if they do know what happened to them, it may be incidental to everything else that happened [during the attack].”

But once a woman has been strangled, she is 750% more likely to be murdered by that same partner, according to the Training Institute on Strangulation Prevention.

That’s why it is crucial for paramedics and police officers who respond to domestic violence events to know what questions to ask, Anderson and Sigmond said. Proper screening can result in a strangulation survivor getting a medical examination, and doctors who are trained in strangulation prevention know to order tests that can reveal significant internal injuries if they are present, they said.

An understanding of what happened and the associated danger can empower a survivor to escape from the situation, and accurate documentation of the assault and related injuries can help survivors obtain justice in court, advocates say.

According to Empowerhouse’s data, 190 women who called the organization’s hotline in 2019 disclosed that they had been strangled, representing 12 percent of total calls. Nineteen percent, or 227 total women, disclosed strangulation when they were spoken to in-person by Empowerhouse advocates.

Anderson said emergency room doctors and nurses, as well as forensic nurse examiners and medics, can receive continuing education credits for attending the training.

“Our hope is to assemble a multi-disciplinary team of local professionals to help us develop an implementation plan for our community,” Anderson said. “In order to increase victim safety and hold offenders accountable, everyone has to be trained.”

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©2020 The Free Lance-Star (Fredericksburg, Va.)

McClatchy-Tribune News Service

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