Injuries of Women Surviving Intimate Partner Strangulation and Subsequent Emergency Health Care Seeking: An Integrative Evidence Review.
Michelle Patch, Jocelyn C Anderson, Jacquelyn C Campbell
PMID 29292069WHAT IT FOUND
Many women do not seek care after intimate partner strangulation, and those who do often minimize injuries or hide the cause.
Serious internal damage like stroke can occur without visible external marks, so a normal exam does not rule out life-threatening injury.
Key findings
01Serious vascular and neurological injuries, including carotid artery dissection and stroke, were documented in case reports even when initial exams appeared normal or patients were discharged.
02External injuries are frequently absent or difficult to see, particularly in darker skin tones, with visualization rates ranging from 7% to 85% depending on the method used.
03Most women do not disclose the mechanism of injury to healthcare providers, and many minimize their symptoms, leading to misdiagnosis or inappropriate treatment plans.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The evidence base is sparse and primarily observational, with no prospective or longitudinal studies included. Case reports and small samples may overrepresent extreme or severe presentations, limiting generalizability. Reliance on self-report introduces recall bias, particularly given the traumatic nature of the events. Definitions of strangulation varied among participants, with some distinguishing between 'choking' (hands) and 'strangulation' (ligature), which may affect data consistency. Most studies included only women who had already sought services, potentially missing those who never accessed care.
Declared interests
No conflicts of interest or funding sources were reported in the provided text.
The easy way to misread this
Do not assume a patient is safe or uninjured because they have no visible neck marks or a normal initial exam. Serious injuries like carotid artery dissection can be internal and delayed, and women often minimize their symptoms or hide the cause of injury due to fear or lack of awareness.