E-News: Five Important Tips/Resources for EMS and Paramedics
Dear Friends,
Welcome to another edition of the Strangulation Prevention E-News. The Training Institute on Strangulation Prevention launched E-News to share important information about non- and near-fatal strangulation assaults. Each E-News focuses on one subject, highlights one organization or individual, and/or shares one featured resource. 
For this E-News, we want to share five important tips and/or resources from our faculty to paramedics and EMS personnel.

Thank you for all you do to help victims find hope and healing through your various responses in investigations, forensic exams, prosecutions, monitoring, counseling and advocacy. Your work matters.
With Great HOPE, 
Gael Strack, CEO and Casey Gwinn, President
1 . Consider passing and/or adopting California’s Duty to Warn Law:

In 2014, California passed a new law requiring law enforcement to warn victims of the lethality of strangulation assaults and the need for immediate medical attention under Penal Code section 13701(I). 


·      Lethality: If a victim is strangled even one time, she is 750% more likely to
be killed by her abuser (Glass, et al, 2008). And if she is strangled multiple
times, the risk of being killed jumps much higher and risk of internal injuries
and long-term health consequences also increases. (Messing, et al, 2018).
·      Risk of Internal Injury: Researchers discovered that 1 out of 47 their
strangled victim/patients are likely to experience a carotid dissection. (Zuberi,
et al, 2019).
·      Risk of Stroke: It is well known that damage to the carotid arteries can lead
to a stroke and/or death. (Hawley, et al, 2001; Zuberi, et al, 2019; Leichtle, et
al, 2010).
·      Easy to Miss: Strangulation injuries are often internal. Most strangulation
victims may have no external visible injuries (50%) or very minor injuries --
making it easy to miss a life-threatening injury without proper immediate
assessment accurate diagnosis and treatment. (Strack, et al, 2001; Brady, et
al, 2022).

2. Watch this 1-minute clip from Dr. Smock why medical treatment is necessary.

3. Provide Strangulation Training to your Paramedics and EMS personnel.

Only a few states and cities have passed laws, ordinances and/or protocols requiring law enforcement and emergency medical services to receive training in the identification, documentation and investigation of non-fatal strangulation assaults in domestic violence cases . Without training, strangulation will be missed, minimized and/or treated as a minor assault. According to Ken Shetter, Former Mayor of Burleson, “the number of aggravated assaults increased dramatically in Burleson the first year after the ordinance was passed because cases were getting correctly charged because better evidence was developed on the scene and because the use of the checklist helped identify more cases of strangulation… victims were transported to the hospital by ambulance after on-scene evaluation by EMS in about 20% of the incidents.”

Fortunately, many police agencies are now updating their domestic violence law enforcement protocols to include this best practice which is encouraged by the International Chiefs of Police.

4. Watch this one-minute clip about the Strangulation Assessment Card.

The Assessment Card was developed by paramedics for paramedics. It provides essential information about the signs and symptoms of strangulation, key steps for paramedics at every domestic violence response, advice when to transport, warnings about delayed consequences, information for victims when to seek medical attention if they refuse transport and a notice to medical providers about the need for imaging. This is also a tool any professional can use. Joyce Bilyeu, Director of Client Services, at the Sacramento Family Justice Center provides a copy of the Strangulation Assessment Card to every client. She educates survivors about the seriousness of strangulation, the need for medical treatment and how to advocate for imaging in the event she seeks medical attention.
  • August 30 – One-Day Hybrid Strangulation Prevention for Canadian Professionals, Virtual (Registration Link)

  • September 6 Virtual 2 Hour Strangulation Prevention, SD Human Trafficking/CSEC Advisory Council

  • September 9 & 16 – Pediatric Strangulation Prevention, Virtual (Registration Link)

  • September 14 & 15 2 Day Strangulation Prevention, Port Gamble, WA

  • September 21 – 1 Half Day Strangulation Prevention, Marine Corps, San Diego, CA

  • October 5 & 6 – 2 Day Strangulation Prevention, LAPD, Los Angeles, CA

  • October 6 – Virtual 1 Day Strangulation Prevention, Battle Creek, MI

  • October 13 & 14 – 2 Day Strangulation Prevention, Stark County, OH

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