Q: How long does it take for someone to die if their carotid artery is compressed?
A: The two carotid arteries lie in the front of the neck on either side of the trachea (windpipe) and carry
blood from the heart to the brain. They supply 90% or so of the brain’s blood, with the rest coming from
the two small vertebral arteries that travel along the spine and over the back-most portion of the brain.
The carotids are interconnected in the brain so that in a normal individual compressing a single carotid
artery will have little effect. Compressing both can cause a loss of consciousness in 15 to 20 seconds and
death in 2 to 4 minutes.
One general rule in medicine is that if the heart stops, the victim will lose consciousness in about 4
seconds if standing, 8 if sitting, and 12 if lying down. This simply reflects the effects of gravity on blood
flow. These numbers would also mostly hold true if both carotids were suddenly pressed shut—not easy
to do—see below. But, to the brain, the complete interruption of blood flow through carotids would look
the same as it would if the heart had stopped. Either way, the brain would receive no blood supply, and
the brain needs a continuous supply of blood to function and survive.
Another medical truism is that dizziness, loss of consciousness, and sudden death are simply gradations
along the same scale. That is, what makes you dizzy can make you lose consciousness, and what makes
you lose consciousness can cause death. One of the things that can do this is compression of the carotid
arteries. Brief compression, can cause dizziness, longer compression can cause loss of consciousness, and
even a longer period of compression can cause death.
A major variable in play here is how severely the arteries are compressed. If only partially collapsed, the
victim might have no problems. Severe and almost complete compression can cause loss of consciousness
and death in short order. And anywhere in between. Significant and potentially deadly compression can
result from strangulation–either manual or ligature–hanging, or an aggressively applied choke hold.
So, depending upon the nature, force, and duration of the compression, your victim could have no
symptoms, become dizzy, lose consciousness, or die. Or could progressively move from one of these to the
next. The time required for death could be a couple of minutes or many minutes if the compression is less
severe or intermittent. As the victim struggled, he could intermittently release the strangle or choke hold
and this would prolong the ordeal.
All these variable means that you can have it almost anyway you want. The killer could overpower the
victim, render him unconscious in 20 seconds, and kill him in 2 minutes. Or the struggle could go on for
many, many minutes. It’s up to you.
Five Last Acts (Docker, 2007) devotes a chapter to the use of a padded tourniquet or a ratchet tie-down to
compress the carotid arteries without pressuring the windpipe. When the oxygenated blood to the brain is
blocked, consciousness is lost within seconds. The arteries are located at either side of the neck as follows:
"With the head tilted back, feel for the Adam's apple with two fingers. Slide your fingers back towards you
into the gap between the Adam's apple and the strap muscle [the easily identifiable muscle running up the
side of the neck from the shoulder blade to the hinge of the jaw] and feel for the carotid pulse."¹
Amongst the evidence for compression is the massive amount of cases of unintentional death by
autoerotic asphyxiation.
Pressure on the neck can close the airway (trachea, or windpipe) at the front of the neck, or compress the
common carotid (both sides of neck) and vertebral (back of neck) arteries or jugular veins (both sides), or
some combination of the above. The jugular veins are easiest to compress, followed by carotid and
vertebral arteries, followed by the trachea. (See 'Hanging' chapter for details.) Much more pressure is
needed to close the airway than to close the blood vessels in the neck, and is unnecessarily painful. It is
entirely feasible to protect the airway with stiff padding, and still kill oneself by tightening a ligature
around the neck, thus shutting off blood flow to or from the brain.
Because they operate at higher pressure, the carotid arteries (blood into the head) require more external
pressure to compress than do the jugular veins (blood out). A tight, quickly-applied ligature would squeeze
both shut, leaving a body with a dusky, blue-tinged (from de-oxygenated hemoglobin in the blood) face.
Lesser pressure, compressing the major veins but not the arteries, would allow blood into, but not out of,
the head. This would result in a swollen, blue-purple head, often leaking blood. It may also be painful,
albeit briefly. If aesthetics are an issue, quick and complete compression of the blood vessels is least likely
to leave a gruesome corpse.
(1) knotting a rope or piece of cloth around the neck in such a fashion that it will not come undone when
consciousness is lost; (2) twisting a stick or rod under the ligature so that it tightens, and then stays caught
under the jaw or chin after unconsciousness,
Method one is straightforward: a ligature is wrapped once or twice around the neck and quickly knotted.
This often looks similar to a homicidal strangulation, but can usually be distinguished from it by the
absence of scratches on the neck (produced either by the attacker or the victim) and of internal neck
injuries.
Method two is rather like applying a tourniquet. There is generally a single loop which is attached loosely
and usually knotted with a granny or reef knot.( A rod (still called a "Spanish windlass" in honor of its
former use in that country for judicial executions) is placed under the ligature and twisted to tighten.
Tightening needs to be accomplished fairly quickly in order to get a few extra twists in before
unconsciousness intervenes. This is done because the twist may partly unwind when no longer held in
place. But only partly. Usually the rod hangs up on the side of the jaw, and enough compression is
maintained to cause death. Occasionally, quite unwieldy rods are used to tighten the ligature, as in a case
where a man used a fireplace poker. items this large will certainly prevent the ligature from untwisting, but
are hard to tighten rapidly.
From Five Last Acts by Chris Docker (2007):
COMPRESSION
There are a number of variations on the "compression technique" depending on personal preferences and
availability of equipment. Marjorie's story illustrates the Tourniquet Method (which is the most common
method in this category). The other major variation is the Ratchet Tie-Down, which is explained in detail
afterwards. All the various compression methods involve compression of the carotid arteries without
interrupting the breathing.
MARJORIE'S STORY
It had happened quite unexpectedly. What had seemed like a routine trip to hospital suddenly developed
into something serious. They would do everything the can, but Marjorie's was not expected to recover.
Her careful plans to make sure the end was at a time of her choosing were not going quite as expected. In
hospital, she had no access to pills or helium. She lay awake for a couple of nights making her plans, going
over all the possible materials and making her choice. It didn't take too much to ask the nurse to bring her
handbag for her so she could get one or two small items. She wanted her mirror and her lipstick, but most
importantly, she knew that in the inside zipped compartment were a pair of stockings. She had also
managed to hide a spoon from dinnertime - a good metal spoon, proper cutlery, not like the stuff you got
in some of the places she had been in.
Marjorie made sure her "implements" were in a place were she could get at them easily, without making
any noise that would attract attention, and not somewhere the nurse might find them and wonder what
on earth this quiet little lady was going to do with them. She waited until the early hours of the morning
when the ward was quietest until she made her move. Under the cover of the bedclothes, she made her
preparations. This was where all the dress-rehearsals would now come in handy! If she hadn't practiced
many times beforehand when she was fit and healthy, working it all out now may well have been beyond
her: but she know what she was doing. Taking one of the stockings, she knotted it loosely but comfortably
around her neck. She wanted to allow about three or four inches when the loop was pulled and the elastic
of the stocking was at its full stretch. Too much and the process would be cumbersome. Too little and the
stocking would be uncomfortable even before she started. She tied it in a good knot that couldn't slip - a
"reef knot" I believe they called it, she reminded herself.
She remembered the many times she had practiced the technique, using her thigh at first so she could see
what she was doing. If you started with the stocking looped around your thigh, one end in each hand, then
knotted it - right over left and tuck it under, that was the natural way to do it. The second knot, the one
that made it so it wouldn't come undone, started the opposite way: it went, left over right and tuck it
under. (If you did two "rights over lefts", you ended up with a "granny know" or slipknot.)
Carefully she positioned the loop around her neck so it was high up, well above where a man's Adam's
apple would be. She knew that having it low on the neck would cause discomfort, since pressure lower
down would compress the windpipe, which was not her intention. Marjorie decided to slip part of the
pillowcase under the loop as well - not strictly necessary, but when the nylon was tightened, it could dig in
to the skin a bit, so she might as well make it comfy with some padding. Next she slipped the spoon
between her neck and the nylon of the stocking. Then she tightened the nylon loop as if tightening a
tourniquet. In the practice sessions she had used a variety of implements that came to hand, some were a
bit longer, some the length of a spoon. She had experimented turning the spoon in one direction and then
the other to see which suited her best. After several turns she could feel it was quite tight - not far to go
now. The spoon would not unwind itself - it tended to catch on the jaw or collarbone - but Marjorie would
be lying down, so there was also the bed there and she could be sure that, once the desired pressure had
been achieved, it would remain.
Marjorie spent a few minutes lying quietly and pausing. Once more, she warmly reviewed all the
wonderful things she had enjoyed in her life. She thought of her loved ones, and the sealed letter she had
placed in her bag addressed to them, making sure they knew she was ending her life in the way she
wanted, and that it was her decision alone, her wish.
Then she tightened the tourniquet another few turns until the woozy feeling started to come over her.
One more turn. The pressure was compressing the carotid arteries. Marjorie lay on her side, inclined
downwards, breathing calmly as she fainted. No fresh blood reached her brain. Five minutes later,
Marjorie was dead.
Successful suicides have been recorded in the medical literature with twomethods - continuous looping
and suspension.
a) CONTINUOUS LOOPING means simply passing a cord around the neck quickly with many turns, using a
material that doesn't slip. Nylon coated cords, for instance, tend to slip, whereas many cords (such as
traditional string) create a certain amount of friction. Simple knots with some of the turns may help. Once
the cord has been wrapped tightly around the upper part of the neck it tends not to slip and, if there is
sufficient pressure to occlude the arteries, death results. This variation is only recommended in an
emergency (for instance if no other materials were available). You need to be agile enough to wrap the
cord quite quickly for a lot of turns. For comfort, some padding is desirable, especially if using thing cord
or string.
b) SUSPENSION is a gentle method that has been recorded frequently in the medical literature. It does not
require suspension of the whole body (as in hanging), but simply uses the weight of the upper body to
apply pressure via a large loop or strap to the carotid arteries. The loop can be attached to any fixed object
such as a door handle, hook, stair rail or kitchen bar. The loop is placed around the neck in such a way
that, by slumping forward (facing the floor), pressure is placed on the carotid arteries. The carotid arteries
are compressed with as little as seven pounds of pressure (the jugular veins with even less - about four
and a half pounds). This varies greatly between individuals, but is quite small, which is why a sitting or
semi-reclining position is sufficient. A massive 33 pounds of pressure, in contrast, are needed to compress
the airway. Suspension does not require much knowledge and can be accomplished even by invalids.
HOW TO FIND THE CAROTID ARTERIES
This is usually quite easy (but don't worry if you can't find them!). The instructions from St John's
Ambulance read: "With the head tilted
back, feel for the Adam's apple with two fingers. Slide your fingers back towards you into the gap
between the Adam's apple and the strap muscle [the easily identifiable muscle running up the side of the
neck from the shoulder blade to the hinge of the jaw] and feel for the carotid pulse." You are feeling under
the jaw bone at the front/side of the neck. Use the pads of the fingers rather than fingertips or thumbs.
Some people have a stronger (or more apparent) pulse here than others. In workshops, most, but not all,
participants were able to identify the carotid artery successfully. Knowing were it is will make it easier to
understand what you are going to accomplish when you compress it with the ligature, but don't worry if
you can't feel the pulse. A WORD OF WARNING
It has been argued that the brain stem (that part that controls automatic functions that continue even into
permanent vegetative state when the brain has died) has its own blood supply which, in theory, could
mean that a person using the compression method could suffer brain death, but with the body continuing
to breath. There seem to be no cases of this happening in the medical literature. There are many reported
cases of successful suicide with the compression method alone. If, however, you wished to take extra
precautions, a small to medium bag placed over the head and slipped under the tourniquet or tie-down
would ensure the breathing would stop.
The compression method is particularly suited for unforeseen circumstances, such as hospitalization.
When in such a desperate "emergency" situation, detailed fine tuning may seem superfluous.
WHAT YOU NEED
* Only household equipment is needed, although any of the following may come in useful: * Stockings,
bowtie, rope, flex, window sash-cord or webbing. The type of material used in a ratchet tie-down is quite
adaptable and can be purchased easily (you can use almost anything from which you can make a
tourniquet loop - be inventive!). Note that some neckties tend to be "stretchy" and are less than suitable;
stockings, on the other hand, will only stretch so far. * Padding. If you can obtain one, a foam cervical
collar (buy on the Internet from medical suppliers) is excellent, but almost any padding will do. * A plastic
bag if desired. * Mixing spoon, large pen, sturdy artist's brush, or similar (anything which you can use as a
rod to turn the tourniquet).
Although favorite materials can be obtained in advance (and especially for practice purposes), suitable
implements can be found in most situations and environments with a minimum of fuss or trouble. You
might even want to make an occasional habit of looking round a new room or environment and thinking,
MAIN FEATURES
Compression provides a simple method of ending one's life that is not dependent on having previously
acquired equipment to hand. Properly done, there is little or no discomfort and it can be performed
without arousing too much unwanted attention. The ease with which it can be done makes it suitable both
as a mainstay method or for emergencies if one becomes confined to a nursing home or hospital bed.
GENERAL DESCRIPTION
Pressure is applied by one of a number of means such that the arteries and veins in the neck that supply
blood to and from the brain are compressed, though without enough pressure to compress the windpipe.
(In the classic judo "choke", for instance, which uses the same principle, pressure is often achieved by
pulling cross-wise on the lapels.) Without a fresh supply of oxygenated blood, the brain then dies within a
few minutes. (Allow 20 minutes, however, to ensure you will not be disturbed.) As with other methods of
starving the brain of oxygen, interruption early on could lead to brain damage.
WHAT IS THE EVIDENCE FOR COMPRESSION?
The evidence for compression comes from three main sources. Firstly, in the medical literature, many
cases have been reported. Secondly, in the academic literature concerning sexual deviance, many cases of
auto-erotic asphyxiation are known (one partner applying pressure to the other's neck to obtain a "high"
by partial stopping of oxygen to the brain, or self-induced compressions for the same purpose - the
fatalities occur when the pressure is continued for too long). Thirdly, the technique used by martial arts
experts (and for some time the police) of applying pressure to an opponent is well understood.
SOME FURTHER STORIES FROM THE MEDICAL LITERATURE
1. A woman aged 73 was lying full length on the floor of a bedroom, which she shared with another
patient in a nursing home. The bed clothing had been thrown back in a manner consistent with getting out
of bed. There was no signs of any struggle. She was dressed in a nightgown and a brown stocking was
round her neck; the fellow of a pair was seen suspended over the head of the bed. The stocking was
applied with a half-knot at the nape on the first turn and with another half-knot at the front of the neck.
The first turn was tight, but the second, although close to the first, was easily released. There were no
other signs of violence, but a little bleeding, which produced a small stain 1 in. in its diameter, had
occurred from the nose; the stain was directly below her nose. Her face and neck, above the ligature, were
congested and of purple color. Bleeding had occurred beneath the conjunctivae [eyelids], but petechial
haemorrhages [pinpoint haemorrhages often found in asphyxia] were not seen in the skin of the forehead
and face. The tounge protruded, but was not bitten; she had dentures, but these were on her bedside
table. 2. In one case, however, a 53-year-old man succeeded. ... He wrapped twine around his neck 35
times, tied a knot and tightened it. He then bent forward on his knees with his head down, which
increased his neck circumference, and thus, pressure from the twine; this is the posture in which he was
found. Since this is an unusual position, the police were initially suspicious. However, there was no internal
damage to the fairly delicate anatomical structures in the neck, a fact consistent with suicide, but not
murder.
There are many more case histories, often with ingenious variations. Additionally, the case histories in
autoerotic asphyxiation show examples of unintentional death.
HOW QUICKLY DOES IT WORK?
Like helium, compression works by starving the brain of oxygen and takes no more than a few minutes.
ARE THERE ANY UNPLEASANT SIDE EFFECTS?
There may be slight discomfort from the pressure on the neck, though this is not enough to interfere with
breathing. As the blood supply to the brain is interrupted, there is a sense of dizziness or fainting, followed
by unconsciousness and death. Judo practitioners have described their experience of losing consciousness
from compression-technique judo holds as "quite pleasant", like controlled fainting.
CHECKLIST:
* You need two items: something you can make a strong loop with, and something you can use to tighten
the tourniquet. Make a list of suitable household items. Even get into the habit of looking around or
imagining yourself in other situations such as hotels, nursing homes, or on holiday - what would you be
able to use in an emergency? You will find there are types of material that are more comfortable, but
stockings are fairly easy to obtain at any hour of the day or night (for instance, from 24-hour petrol
stations). * If using an elasticized material (such a stockings or tights), make the loop the size you want
when the material is at its maximum stretch. * A fraction of the pressure that would compress the
windpipe is needed to compress the carotid arteries (these supply oxygenated blood to the brain). Avoid
placing pressure on the windpipe, though, by keeping the loop higher around the neck rather than lower
down. Padding may be used for extra comfort - find out by experimenting with different loops and see
which ones are comfortable without padding (don't cut into the skin) or which ones need padding. *
Practice making the tourniquet on your thigh first, rather than your neck. This allows you to see what you
are doing. Make sure you can do the knot easily. * When you come to practice the tourniquet around your
neck, maybe have a pair of scissors handy to cut the practice stocking (or cord), should you need to. * A
wooden kitchen spoon is excellent for practice. Try turning it until you can feel the pressure (but not
causing you to feel dizzy or faint). See how it catches on the collar bone or jaw. Decide if turning it in one
direction or the other feels to work better for you. * The tourniquet "level" can be placed at any point, but
at the side and towards the front of the neck is perhaps easiest and most comfortable. * The pressure
needed for self-deliverance is the same pressure that is needed to cause you to become dizzy and faint, so
exercise due caution during your dress rehearsals.
The difference between a reef knot (when making a tourniquet) and a granny knot.
The tourniquet in question is just a ligature, that is, a piece of rope, stockings, bowtie or similar tied
around the anatomical structure, secured with a reef knot, and tightened with a rod or stick. There are
two options: either something broad and flat, like a belt, or a thin string with padding applied to prevent it
from eating into the neck. In the case of padding, you need to strike a balance so that the ligature is still
able to compress the arteries.
If you can produce same the woozy feeling as when compressing the arteries with the pads of your fingers,
then you're off to go.
From Suicide and Attempted Suicide by Geo Stone (1999):
Asphyxia is any process that cuts off the oxygen supply to the brain. This includes such seemingly
unrelated methods as a plastic bag over the head, suspension hanging, and carbon-monoxide poisoning.
All forms of asphyxia are potentially lethal, but they differ widely in how painful they are. Death usually
occurs between five to ten minutes after complete asphyxia. Some of these methods are suitable for
suicide; none are appropriate for a suicidal gesture.
LETHAL INTENT: High FATALITY RATE: High; around 80 percent PERMANENT INJURIES: Moderately likely
PROS AND CONS OF SUICIDAL ASPHYXIA PROS: * Can be quick and painless, if done knowledgeably * Does
not require much strength or equipment * Some methods can be carried out by a person unable to get
out of bed CONS: * Possibility of brain damage if asphyxia is interrupted * Some methods leave a
gruesome cadaver
WHAT IS ASPHYXIA?
In the most general sense asphyxia is any conditition that causes the heart to stop beating by interfering
with the body's capacity to inhale or utilize oxygen. Oxygen is ultimately necessary for all human
metabolic activity, and its absence is rapidly fatal. Since the brain is the organ most sensitive to lack of
oxygen, as a practical matter asphyxia is anything that cuts the brain's supply of, or ability to use, oxygen.
Obviously the rest of the body needs oxygen, too, but the brain responds most quickly and catastrophically
to its absence.
HOW AND WHY IS ASPHYXIA DANGEROUS?
Death is a process, rather than an event. Different cells and tissues die at different rates; for example, the
brain will not normally survive more than a few minutes without oxygenated blood circulation, while
connective tissue and muscle cells main remain alive for many hours. This is one reason for the current
medical ability to reattach severed limbs, but not heads.
At a basic level, all asphyxial injury is due to cutting off the brain's oxygen supply. This can happen directly,
by interference with breathing (for example, from pressure on the chest or on the front of the neck) or by
removal of the oxygen from the air. The same results occur indirectly if blood can't pick up oxygen (for
example, in carbon-monoxide poisoning), or if oxygenated blood is prevented from reaching the brain (for
example, by pressure on the large arteries in the neck). Irrespective of the method, complete asphyxia
causes quick - typically within 2-3 minutes - unconsciousness, followed by brain damage, ending in death.
Since the degree of oxygen depletion varies with method, so does the length of time needed for any given
result.
Resuscitation may produce a survivor with brain damage, which is often long-lasting and sometimes
permanent. Four to five minutes of circulatory arrest causes brain damage in around half of patients and
approximately 5-10 minutes of complete oxygen cutoff is generally fatal (unless body temperature is
abnormally low, as in drowning in icy water), though the heart will continue to beat for several more
minutes.
Let's look at some of the methods in more detail.
STRANGULATION
Strangulation causes asphyxia by means of pressure on the neck from a ligature or from someone's hands.
The weight of the victim's body plays no part, which is what distinguishes strangulation from hanging.
Since manual self-strangulation is unknown and probably impossible (your hands relax when you become
unconscious), all cases of manual strangulation are considered homicides. I suppose this also makes
manual self-strangulation the perfectly safe suicidal gesture, but, by the same token, it would not likely be
taken seriously.
Pressure on the neck can close the airway (trachea, or windpipe) at the front of the neck, or compress the
common carotid (both sides of neck) and vertebral (back of neck) arteries or jugular veins (both sides), or
some combination of the above. The jugular veins are easiest to compress, followed by carotid and
vertebral arteries, followed by the trachea. (See Hanging chapter for details.) Much more pressure is
needed to close the airway than to close the blood vessels in the neck, and is unnecessarily painful. It is
entirely feasible to protect the airway with stiff padding, and still kill oneself by tightening a ligature
around the neck, thus shutting off blood flow to or from the brain.
Because they operate at higher pressure, the carotid arteries (blood into the head) require more external
pressure to compress than do the jugular veins (blood out). A tight, quickly-applied ligature would squeeze
both shut, leaving a body with a dusky, blue-tinged (from de-oxygenated hemoglobin in the blood) face.
Lesser pressure, compressing the major veins but not the arteries, would allow blood into, but not out of,
the head. This would result in a swollen, blue-purple head, often leaking blood. It may also be painful,
albeit briefly. If aesthetics are an issue, quick and complete compression of the blood vessels is least likely
to leave a gruesome corpse.
Suicidal strangulation is uncommon, but certainly not unknown. It is generally done by one of three
means: (1) knotting a rope or piece of cloth around the neck in such a fashion that it will not come undone
when consciousness is lost; (2) twisting a stick or rod under the ligature so that it tightens, and then stays
caught under the jaw or chin after unconsciousness; (3) wrapping multiple turns of cord around the neck
without any knot at all, depending on friction to hold it in place.
Pressure on the windpipe is painful, but even lethal pressure elsewhere on the neck may produce little or
no distress; thus, if the front of the neck is well padded, none of the following techniques ought to be
particularly painful. But all are potentially deadly.
Method one is straightforward: a ligature is wrapped once or twice around the neck and quickly knotted.
This often looks similar to a homicidal strangulation, but can usually be distinguished from it by the
absence of scratches on the neck (produced either by the attacker or the victim) and of internal neck
injuries.
A more-or-less typical case of a suicidal strangulation is described in a forensic medicine text:
A woman aged 73 was lying full length on the floor of a bedroom, which she shared with another patient
in a nursing home. The bedclothing had been thrown back in a manner consistent with getting out of bed.
There were no signs of any struggle. She was
dressed in a nightgown and a brown stocking was round her neck; the fellow of a pair was seen
suspended over the head of the bed. The stocking was applied with a half-knot at the nape on the first
turn and with another half-knot at the front of the neck. The first turn was tight, but the second, although
close to the first, was easily released. There were no other signs of violence, but a little bleeding, which
produced a small stain 1 in. in its diameter, had occurred from the nose; the stain was directly below her
nose. Her face and neck, above the ligature, were congested and of purple colour. Bleeding had occurred
beneath the conjunctivae [eyelids], but petechial hemorrhages [pinpoint hemorrhages often found in
asphyxia] were not seen in the skin of the forehead and face. The tongue protruded, but was not bitten;
she had dentures, but these were on her bedside table. The author goes on to describe the generally mild
injuries in detail and concludes, "The cause of death was asphyxia, following the application of a relatively
broad, soft ligature to the neck with sufficient force to obstruct the veins and, to a lesser degree, the
arteries of the neck; there was also obstruction of the air passages. The mode of application of the ligature
was consistent with self-strangulation, as was all the other evidence."
Sometimes it's difficult to determine whether death resulted from suicidal or from homicidal
strangulation. For example, a soft ligature applied with skill and removed soon after death will create
problems at autopsy. In one case a woman strangled her child with her husband's necktie. She tied no
knot and held the ends of the necktie instead, until the deed was done, and then removed it. As a result,
there was no externally-visible neck injury. But she was caught anyway.
It isn't unusual for defense counsel in a case of homicidal strangulation to try to muddy the waters. In one
instance, the body of a 42-year-old woman was found in a grave in her well-screened back yard.
Clothesline was wrapped twice around her neck and tightened with a half-knot. A man was arrested. At
trial, the defense described the ligature as more like a "lover's" knot than a murderer's; but had a hard
time explaining the presence of a large piece of cloth forced down her throat, and several additional
injuries. Faced with this evidence, counsel admitted that the injuries were the cause of death, but
suggested that they were the results of a violent quarrel. The accused's failure to report the death was
attributed to his preference for conducting his own funeral arrangements. His contention, that he wanted
to give her a "Christian burial," was described by the prosecutor as one of the worst pieces of hypocrisy he
had ever heard. The jury was equally unimpressed by his solicitude and convicted him of murder.
Method two is rather like applying a tourniquet. There is generally a single loop which is attached loosely
and usually knotted with a granny or reef knot. A rod (still called a "Spanish windlass" in honor of its
former use in that country for judicial executions) is placed under the ligature and twisted to tighten.
Tightening needs to be accomplished fairly quickly in order to get a few extra twists in before
unconsciousness intervenes. This is done because the twist may partly unwind when no longer held in
place - but only partly. Usually the rod hangs up on the side of the jaw, and enough compression is
maintained to cause death. Occasionally, quite unwieldy rods are used to tighten the ligature, as in a case
where a man used a fireplace poker. Items this large will certainly prevent the ligature from untwisting, but
are hard to tighten rapidly.
Method three, multiple loops, is the least common since, if the ligature is tight, there isn't time to do very
many loops; if it is loose, it's ineffective. In one case, however, a 53-year-old man succeeded despite these
difficulties. He wrapped twine around his neck
35 times, tied a knot and tightened it. He then bent forward on his knees with his head down, which
increased his neck circumference, and thus, pressure from the twine; this is the posture in which he was
found. Since this is an unusual position, the police were initially suspicious. However, there was no internal
damage to the fairly delicate anatomical structures in the neck, a fact consistent with suicide, but not
murder.
From Suicide and Attempted Suicide by Geo Stone (1999).
Hanging and strangulation are effective methods of suicide. Both can be carried out by people with limited
physical abilities. Hanging doesn't require complete suspension. Death occurs within about 5-10 minutes
after cutoff of oxygen or blockage of blood flow to the brain (anoxia); however, convulsions are common
and the noise may attract attention. Pain can be minimized by protecting and padding the front of the
neck. Since finding the body will probably be traumatic, care should be given to choosing a location. These
are highly lethal methods and cannot be done safely as a suicidal gesture.
LETHAL INTENT: High MORTALITY: High, around 80% PERMANENT INJURIES IN SURVIVORS: Moderately
infrequent PROS AND CONS OF HANGING AS A MEANS OF SUICIDE PROS: * Quick unconsciousness * Fairly
quick death * Easily accomplished with materials found around the house * Can, if necessary, be done
without leaving bed CONS: * Possibility of brain damage if interrupted * Sometimes a gruesome cadaver,
which may be upsetting for whoever discovers the body
Suspension hanging is often lumped (and confused) with judicial-type ("drop") hanging, suffocation,
strangulation, and even choking. This is entirely understandable, since the subject is confusing, but there
are some important, and sometimes critical, differences between them. Brief definitions of these terms
may be helpful in making sense of what follows.
1. SUSPENSION HANGING: suspension by the neck, with little or no drop. Death is due to compression of
the airway (trachea, or windpipe) and/or the major blood vessels connecting the heart and the brain.
These latter are the carotid and vertebral arteries, and the jugular veins. We will use "hanging" to mean
"suspension hanging" unless otherwise specified. 2. JUDICIAL-TYPE (DROP) HANGING: a several foot drop,
with rope attached to the neck. If everything goes right, death is due to a broken neck. While this is
quicker than suspension hanging, it may or may-not be less traumatic. 3. STRANGULATION: manual
compression of the airway and/or blood vessels to/from the brain. In suicide, this generally requires a
ligature (rope, wire, cloth, etc.). In homicide, there may be a ligature, or there may be direct pressure from
hands or forearm on the neck. 4. CHOKING: blockage of the airway by mechanical obstruction, for
example, a lump of food. 5. SUFFOCATION OR ASPHYXIATION: interference with the ability to take in or
use oxygen; related to choking, suspension hanging, and strangulation, in that oxygen is prevented from
reaching the brain in each case; however there is no direct pressure on the airway in suffocation or
asphyxiation. Examples are, use of a plastic bag, or carbon monoxide. This topic is treated in another
chapter (see Asphyxia chapter).
PHYSIOLOGY: WHAT IS HANGING, AND HOW DOES IT KILL?
Hanging can kill by four distinct mechanisms: compression of the carotid arteries, compression of the
jugular veins, compression of the airway (trachea), and breaking the neck. The first three can result from
suspension hanging; the last from drop hanging.
CAROTID ARTERY: On the right side of your neck, just under the side of the jaw, is one of your carotid
arteries. Put your fingers there and gently feel your pulse. It should be quite strong. (If you can't find one,
either you're looking in the wrong place or you don't need this book.) The carotid artery carries much of
the blood to your brain, which uses around 15% of the entire blood supply of your body. Anything which
interrupts that blood-flow for more than a few seconds will cause loss of consciousness.
JUGULAR VEIN: On both sides of the neck, under the angle of the jaw, are the jugular veins, which carry
the "used" blood back to the heart. If the jugulars are blocked, blood backs up, much like water in a
stream that has been dammed. The carotids and jugulars can be compressed with just a few pounds
pressure; a moderately tightened rope will do nicely. Death occurs within a few minutes. There does not
need to be any pressure on the airway (trachea or windpipe), though there often is.
TRACHEA/AIRWAY: The airway, down the front-center of your neck, can be blocked internally (by inhaling a
foreign object), or externally (by a ligature). When the interference is internal, it is termed "choking". In
either case, obstruction of the airway takes a good deal longer to produce unconsciousness than does
carotid pressure, and is much more painful. (Details are in the Asphyxia chapter.) Sometimes choking is the
cause of accidental death ("cafe coronary") when a piece of food lodges in the airway and can't be
dislodged - so learn the Heimlich maneuver, don't make a pig of yourself when eating, and chew your food
thoroughly - Ma was right about some things.
"Suffocation" is related to choking, but is an interference with successful breathing, rather than direct
blockage of the trachea. Examples include smothering with a pillow or plastic bag, and being killed by a
boa constrictor. (See the Asphyxia chapter.)
Pressure on the neck is sometimes a method of homicide, typically by the use of two thumbs against the
airway and the other fingers grasped round the back of the neck. If the neck constriction is due to the
body's weight pulling on a ligature, it is called "hanging"; otherwise it is some form of strangulation. This is
of some practical significance, since almost all hangings are suicide, accident, or judicial, while most
stranglings are homicide.
HANGING: Judicial (drop) hanging is quite a different kettle of worms from suspension hanging. In
(properly done) judicial-type hanging, the victim falls several feet before coming to an abrupt halt at the
end of a rope. Often, this is the bitter end. Such a precipitous change in velocity is supposed to cause a
broken neck and quick unconsciousness and death. However, exhumation of judicial hanging victims has
shown that the breaking of the neck was frequently not the cause of death. An excessively long drop can
result in separation of head from body, and is considered bad form by professional hangmen.
Suspension hanging can cause compression of the carotid, jugular, and/or airway, depending on how it is
carried out.
There are similarities between suspension-hanging and choking, as well as the previously-mentioned
differences. Your blood carries oxygen and nutrients to your brain. Enough pressure on the airway
(trachea/windpipe) compresses it and prevents oxygen from reaching the lungs. Your body has built-in
reflexes to keep this from happening; pressure against your trachea causes quick pain, and you have an
irresistible urge to relieve the pressure and cough; one reflex (pain) gets your attention and tries to get
you away from the stimulus - say, someone's thumbs - and the other reflex (cough) attempts to clear the
airway. If these attempts are unsuccessful, blood will continue to be pumped to the brain (and elsewhere)
by your heart, but it won't carry enough oxygen and you will lose consciousness in a couple of minutes.
TIME TO DEATH: As asphyxia proceeds, first temporary, then permanent, brain damage from lack of
oxygen will occur. Death follows in 5-10 minutes (10-20 minutes, according to Polson; however, his
number seems to be based on the fact that the heart may continue beating for up to 20 minutes after
judicial hanging, and ignores that the heart may continue to beat after brain death. While human data are
lacking, unanesthetized dogs die after around eight minutes of asphyxia). On the other hand, it's also true
that unconsciousness and death will be delayed if blood-flow to/from the head is only partially obstructed.
CAROTID REFLEXES: Curiously, you don't have the same protective reflexes along the carotid artery, so that
pressure sufficient to block the artery doesn't elicit much in the way of defensive reaction. In fact, one of
the reflexes that is present may be counterproductive: near where the carotids divide are some nerve
cells, the "carotid sinus". These nerve cells have the normally-useful function of maintaining blood
pressure at a steady level. They respond to a decrease in blood pressure (for example, when you stand up)
by constricting arteries and telling the heart to beat harder. Without this, you might pass out every time
you stood up suddenly, because not enough blood was reaching your brain. (The dizziness many people
feel when they stand up suddenly is another way of appreciating how quickly and exquisitely sensitive
your brain is to absence of enough blood.) Similarly, the carotid sinus responds to an increase in blood
pressure by relaxing the arteries and inhibiting the heart.
So far, so good. The problem arises because these pressure-receptor nerves aren't smart enough to tell
the difference between blood pressure and externally-applied pressure - for example, a forearm or billyclub across the right-front side of the neck.
"SLEEPER" HOLD: Those of you who are wrestling (TV variety) fans are probably familiar with the sleeper
hold; it is nothing more than a forearm pushed against the right carotid artery, compressing it, and cutting
off blood flow to the brain (see Asphyxia chapter). This causes unconsciousness in about eight to fifteen
seconds.
The sleeper hold is forbidden in tournament wrestling and is faked in the TV stuff. The reason is that the
amount of pressure needed to compress the artery is enough to cause the carotid sinus to kick into
overdrive and send the heart a priority message to slow down, which is sometimes enough to stop the
heart altogether. Despite being quite aware of this, some police departments continue to use this hold to
restrain people they arrest, with the altogether predictable result of infrequent, but entirely unnecessary,
deaths. Another hazard with the sleeper hold is that, during a struggle, the constricting forearm can shift
from the side to the front of the neck, compressing the airway and becoming a "choke hold". This requires
greater pressure than the sleeper hold, with a corresponding increase in injuries to neck structures, for
example, fracture of the thyroid cartilage. More dangerously, the lack of oxygen to the heart muscle can
trigger fatal cardiac arrest.
In one case, a man's wife sought an involuntary psychiatric commitment order because of his withdrawn
behavior and refusal to take medication. The order was granted and two police officers were dispatched to
his residence to bring him to the hospital. Coaxing by the police officers proved futile. In an attempt to
overcome and handcuff him, one police officer stepped behind the victim and grabbed him about the
neck. The hold intended by the officer was the carotid sleeper with the neck of the victim in the crook of
the arm and forearm of the officer. After a brief but violent struggle during which both the officer and the
victim fell to the floor, the victim became lifeless. He did not respond to cardiopulmonary resuscitation. An
electrocardiogram taken during resuscitation showed cardiac arrest. Witnesses including family members
stated that the entire struggle lasted only a short time with the neck hold in place several seconds. ... An
inquest jury ruled that the death was natural because of the victim's previous cardiac history and the brief
time during which the neck hold was applied.
PRESSURE NEEDED TO COMPRESS THE CAROTID: How much pressure is needed to compress the carotid?
Surprisingly little. To quote the eminent Doctors Polson and Gee,
By experiment I have confirmed that the carotid artery is appreciably obstructed by a ligature under low
tension. Having first established free flow of fluid between the common carotid artery, exposed in the
upper chest, and the internal carotid artery, seen inside the skull after removal of the calvarium, I then
applied a ligature with a running noose round the neck. Weights were added and injection was repeated,
below the level of the ligature. The tests showed that a pull of as little as 7 lb (3.2 kg) was sufficient to
reduce free flow through the artery to a mere trickle.
Obviously, this will vary from person to person, and also with the width of the ligature; other published
values are as high as 11 pounds (5 kg). Two problems with these calculations are that, in a living person,
(a) the carotids are located deeper in the neck than jugular veins and are shielded by a living sternomastoid muscle; (b) blood pressure might open the compressed artery on each heartbeat. More on that in
a moment.
PRESSURE NEEDED TO COMPRESS THE JUGULAR: Since veins operate at lower pressures than do arteries
(if you cut an artery, blood spurts out; blood only flows from a severed vein) one might expect the jugular
veins to be more easily compressed than the carotid arteries. Experimentally, this is exactly the case, with
only around 4.5 pounds (2 kg) pressure needed to block the jugulars.
PRESSURE NEEDED TO COMPRESS THE AIRWAY AND OTHER ARTERIES IN THE NECK: About 33 pounds (15
kg) will compress the airway, and 66 pounds (30 kg) the vertebral arteries leading to the face.
What this means, practically speaking, is that someone who wants - or wants to avoid - a lethal result
should be aware that full suspension is quite unnecessary. Death will occur after only a few pounds of
pressure on a neck ligature; a sitting or semi-reclining position is sufficient.
SUSPENSION HANGING
Hanging does not have a very good image. For example: "The discovery of a grotesquely hanging corpse
whose swollen, sometimes bitten tongue protrudes from a bloated blue-gray face with hideously bulging
eyes is a nightmarish sight upon which only the most hardened can gaze without revulsion." However,
while some look livid, about 60 percent of hangers have a "pale and placid" face. Some have small
hemorrhages, caused by capillaries leaking (due to high blood pressure in the absence of oxygen), on the
face, eyelids, and/or scalp; others don't.
What accounts for these differences? Basically, it's a question of how quickly and totally the ligature cuts
off blood circulation to and from the head. If suspension is fast and complete, the blood supply both to
and from the head will be cut off simultaneously, so there is no excess blood or blood pressure in the
head, and thus a more-or-less normal-colored corpse. Similarly, activation of the carotid sinus pressure
receptor would cause a decrease in blood flow to the head, leading to paleness in the cadaver.
If, on the other hand, the pressure on the neck gradually increased as consciousness was lost, it's probable
that the jugular veins were shut off before the carotid arteries (and almost certainly before the hard-toclamp vertebral arteries), since it requires less pressure to do so. Thus, in this case blood would continue
flowing into the head while having no way to leave it; hence engorgement and blue/purple color. This is
most likely when the suicide is in a sitting or lying position, because there is less (and less sudden)
pressure on the neck than when she/he is completely suspended.
PLACEMENT OF THE LIGATURE: An additional variable is the placement of the ligature. The least pressure
corresponds to the location of the knot in the rope, since that point is pulled up and away from the neck.
It is thus possible to avoid compressing the trachea is the knot is along the centerline of the face.
Further complications arise because the noose can be placed high or low on the neck, with potentially
different intermediate results. When high, it is less likely to compress the airway because some of the
pressure from the ligature may be transferred to the jaw or skull.
DO PEOPLE DIE FROM AIRWAY BLOCKAGE, OR FROM CUTOFF OF BLOOD CIRCULATION TO THE BRAIN?
Bodies with little weight on the ligature, that is, which prone or seated, have a greater chance of death
from asphyxia, according to a standard forensic text. Since the jugular vein (blood out) is easier to
compress than the carotid artery (blood in), enough blood accumulates in the head and neck to compress
the airway, leading to asphyxia.
Medical experts disagree about the frequency and importance of airway blockage in hangings. For
example, one says, "Occlusion of the air passage by constriction on the neck is probably extremely rare if
existing at all." Others hedge their bets: "Suicidal hanging is earmarked characteristically as causing death
by compression of the anatomic airway and the blood vessels in the neck." Or cover all the bases:
"Reports in the forensic literature have stated that death may be due to either asphyxiation, coma, carotid
artery or jugular vein injury, or any combination of the above." Certainly, airway blockage is not essential
to successful hanging. In one case a woman with a tracheotomy killed herself despite attaching the
ligature above the site of the breathing hole. She would have continued breathing until dying from lack of
blood to her brain.
Airway blockage is more likely when:
* the ligature knot is toward the back of the neck. In this situation the maximum pressure from the rope is
then on the front of the neck, where the airway is. * the person is seated, semi-reclining, or prone. Due to
little weight on it, the rope tends not to slide up the neck. Were it to move up, it would end up being
partially supported by the chin, relieving pressure on the airway. * the ligature is thin, or attached with a
running noose. Such a ligature tends to clamp in place. * the ligature is placed low on the neck, where it
tends not to slide up high enough to be supported by the chin.
ACCIDENT
How often are hanging deaths due to accident? Combining four studies of hanging, we find that 96%
(range 94-98%) were suicidal, and 4% (range 2-6%) accidental.
Of the 19 accidental deaths, 5 were children. For the most part, they were toddlers snagged by crib slats
and/or their own clothing. The remaining 14 were all males who had gotten wrapped up in auto-erotic
asphyxiation. To quote from an interesting review of hanging:
Add sexual perversion to the woes of mankind. When men or women try to improve on nature's
biological methods, they not only become frustrated, but worse, act unnaturally, and usually to their own
detriment. Any sexual behavior that strays from the confines of normal physiological compatibility is
considered to be a perversion .One may add to the list another deviation, described by the Marquis de
Sade: self-induced asphyxia as a means of ejaculatory gratification in the form of masturbation. ... When
propelled by concupiscence, the unfortunate person with autoerotic propensities does not suspect that
death lurks nearby.
It seems that increased sexual gratification can be had by partial interruption of oxygen to the brain. There
may also be elements of masochism here. Whatever the motivation, the trick is to make sure the
interruption is, and remains, partial. The problem is that unconsciousness can occur without warning; if it
does, and if the ligature doesn't slip off or loosen, death follows.
These are accidental deaths. The victims are alleged to share some psychological traits with suicides:
depression, death fixation, and isolation. However the circumstances and details of the hangings are
usually quite different; in autoerotic hanging:
* there are often signs of masturbation; * women's clothing, either worn by the victim or found near him,
is common; * erotic literature is frequently found at the site; * there is often a history of successful partial
hangings, evidenced by a diary, a collection of ligatures, or wear marks from the rope on the rafter, door,
or other attachment point; * typically, the neck is protected by padding; * feet are usually on the floor
and/or there is furniture nearby for support; * there are sometimes mirrors or cameras for viewing the
(often bound) genitalia; * generally, there is no history of suicidal attempts; * the victims are almost
always (more than 99%) male, for reasons unknown.
These people die because they lose consciousness quickly and unexpectedly.
Interestingly, asphyxia as a means of sexual arousal is a centuries-old practice documented by
anthropologists. For example, Eskimos (Inuit) apparently choke one another as part of their normal sexual
repertoire, and Eskimo children suspend themselves by the neck in play.
The state of unconsciousness is so important and so familiar to the Eskimos that even the children play at
it. It is a favorite pastime of theirs to hang themselves by their hoods. When these tighten about their
necks, the blood is kept from their heads, and in time they lose consciousness. The other children in the
house take them down when their faces turn purple. But they say that the state of unconsciousness is so
delightful that they play this game over and over again.
STRANGULATION
Strangulation is defined as pressure applied to the neck without suspension of the victim. It is uncommon
in suicide, but not unknown. Nevertheless, most strangulations are homicide, and will be treated as such
by medical examiners and police, in the absence of clear evidence to the contrary. Strangulation was used
as a method of execution in some countries, for example, Turkey and Spain. In Spain, the sitting victim was
tied to a post. A metal collar was placed around the neck and the post, and then tightened. In one version,
a metal spike stuck out of the post and was forced into the base of the prisoner's neck by the pressure of
the tightened collar.
The physiology of strangulation is essentially the same as that of suspension hanging, and needs not be
treated separately. In self-strangulation, the ligature is applied more slowly and less tightly than in
suspension hanging. As a result, the jugular veins are more constricted than are the carotid arteries,
leading to a blue, swollen, head. Neck injuries, however, are rare. Because the ligature cannot slide up the
neck or be supported by the chin, compression of the airway is more likely than in suspension hanging.
In suicidal hanging, people generally use the materials at hand. Women tend to use stockings or scarves;
men most often use cord. In one case a man strangled himself with two bow ties. In another instance, a
man, mistaking himself for a bobbin, wrapped 35 turns of twine around his neck, tied a knot, and attached
the free end to his right thumb in order to increase pressure. Blood alcohol level was 0.26 percent.
Two or more turns tied with a half knot or half hitch (double knots are more characteristic of murder) is
strong evidence of suicide, but there are exceptions. The murdered 42-year-old woman described in the
"Asphyxia" chapter was such a case.
More typical of self strangulation were two women who killed themselves with stockings. In one case, a
73-year old woman, depressed and about to be committed to a mental hospital, wrapped a stocking twice
about her neck. There was a half-knot at each turn. Because the ligature was only tight enough to
compress the jugular vein (blood out) but not the carotid artery (blood in), her face was purple and
congested. In the other example, a similar stocking was pulled more tightly and the face was not engorged
or cyanotic.
It's possible for a person to strangle him/herself with one arm: a woman with incapacitating burns on her
right hand rolled a shawl and scarf into a ligature, wrapped it two-and-a-half times around her neck and
tied two knots.
Another method is use of a tourniquet. A single loop of rope is loosely tied around the neck with a good
knot, for example, square or reef knot. A rod is put between the ligature and the neck and is then twisted
until the desired degree of tightness is achieved. The rod tends to unwind a bit when the person becomes
unconscious, but usually snags on the side of the jaw, maintaining enough tension to cause death. (See
Asphyxia chapter for details.)
CONSEQUENCES: WHAT HAPPENS TO HANGING SURVIVORS?
DROP (JUDICIAL-TYPE) HANGING: There are no survivors of a properly-done drop hanging; the broken
neck (similar to some car-crash neck injuries) is invariably fatal. Even when the neck is not broken, injury is
severe and debilitating, and the victim strangles.
SUSPENSION HANGING: Since only around 1% of suicidal hangings are of the drop type, there are
correspondingly few spinal cord injuries. In suspension hangings, damage to neck structures occurs about
1/3 to 1/2 of the time, but is not normally life-threatening.
Both death and permanent injury are due to cutting the oxygen supply to the brain. The severity of brain
damage depends on how completely and how long the brain is oxygen-starved. Mild hypoxia (not enough
oxygen) causes behavior resembling drunkenness: physical and verbal incoordination, but no permanent
harm.
With complete anoxia (no oxygen taken in, but heart and blood circulation uninterrupted),
unconsciousness occurs after about two minutes and coma in about five. If blood circulation to the brain is
totally stopped, loss of consciousness follows in 8-15 seconds. Recovery may take minutes to days, and
may not be total. After about four to five minutes of anoxia, permanent brain damage becomes
increasingly likely. Five of 39 people rescued from near-hanging had such persistent injury.
On the positive side, there are rare, but well-documented, cases of spontaneous remission of depression
after near-hanging.
DROP HANGING: Drop hanging may not be instantly fatal and, "the possibility of briefly retained
consciousness in some cases appears quite real." You might be wondering how this was determined. In a
study of 34 skeletons of people who had been judicially hanged between 1882 and 1945, a substantial
number did not have a broken neck. Interestingly, the average drop for this group was 83 inches; for those
whose neck was broken the average drop had been only 74 inches. Thus, "the length of the drop, though
important, does not produce expected or consistent results."
In the event of miscalculation leading to an inadequate fall, the victim will undoubtedly suffer some moreor-less severe neck injury, but will die within 5-10 minutes of asphyxiation, carotid/jugular compression, or
tears of the vertebral arteries (leading to massive hemorrhage).
SUSPENSION HANGING: In addition to brain damage, there may be heart and/or lung injury. For example,
there is a syndrome found, among other cases, in hanging survivors; it's called Adult Respiratory Distress
Syndrome (ARDS) and is characterized by progressive respiratory failure that is hard to treat and is not
helped much by
supplementary oxygen administration. The cause is not well understood: it may be due to brain injury
from lack of oxygen; an alternative explanation is that fluid fills the lungs (edema) because of the high
negative pressure in the lungs due to trying to inhale against a blocked airway; other possible mechanisms
have been proposed. In any
case, various types of lung damage are the most frequent cause of delayed death in near-hangings.
PRACTICAL MATTERS: HOW TO DO IT
If you intend to hang yourself, the next major decision is whether to do a drop (judicial-type) or
suspension job. Each has some advantages and disadvantages.
SUSPENSION: (1) can be done with a wide range of ligature materials - most anything will work; (2) can be
carried out by invalids, without leaving their room; (3) is fairly quick, probably not painless (but
unconsciousness is rapid), but may have severe consequences - brain damage - if interrupted; (4) doesn't
require much knowledge to accomplish.
To carry out a suspension hanging, you can simply tie one end of the ligature to a fixed point (doorknob,
hook, rafter, etc.) and the other end to your neck. You can and should protect the airway from
unnecessary compression and pain by firmly padding the front quarter of the neck and (better) by placing
the knot high and at the front of your face.
Complete suspension is unnecessary and is probably more painful than partial suspension; however,
standing on and kicking away a chair is sometimes done in the same spirit as diving, rather than wading,
into icy water. Unconsciousness occurs quickly and without enough warning to count on time to change
your mind: this is a lethal method and is not suitable for a "suicidal gesture".
You need an uninterrupted twenty minutes (half an hour to take into account last-minute vicissitudes) to
be sure that you won't be cut down and "saved" with permanent brain damage. Since you may thrash
around while unconscious, take into account the possibility of attracting unwanted intervention because
of the noise. Because the cadaver is sometimes gruesome and always shocking, consider not hanging
yourself where loved ones will find the body. If you use a hotel or motel, leave a good tip for the cleaning
person.
SUICIDAL STRANGULATION: If, for some reason, there is no attachment point available for a ligature,
strangulation is a possibility. This method consists of wrapping a cord around your neck and tightening it.
The disadvantages are:
(a) depending on the amount of tension applied, it may compress your airway as well as the major blood
vessels (carotid and/or jugular) unless you protect the front of the neck;
(b) since there is no weight on the ligature, it may loosen when you become unconscious. Some methods
to solve this latter problem are:
* use a high-friction ligature that will stay in place;
* use a double knot;
* wrap thin cord, as many times as possible in 5-10 seconds, around your neck, relying on friction to
maintain the tension. A slip knot is helpful, but may loosen unless wrapped;
* make a loose loop around your neck. Insert a thin, rigid item, for example, a wooden spoon or pen,
between the neck and theloop, and twist the rod until it tightens the ligature; thentuck the end of the rod
between the neck and the cord to keep itin place. If you use a bar that is around 8 inches (20 cm) long,
there is a good chance that it will stay in place under your chin even if not tucked in.
The most reliable of these methods is to buy a ratcheting "tie down". These are available at auto,
motorcycle, and some hardware stores for between $5 and $10 and are generally used for attaching cargo.
Once tight, a spring-loaded cam release (or equivalent) must be pressed to remove tension. The main
caveat is that, if you're not familiar with them, it may take a few minutes to figure out how the ratcheting
mechanism works. A friction-actuated version is easier to use and is also easier to release, but can't be
tightened as much, which doesn't matter for this use. In all cases, bending forward increases the diameter
of the neck, and thus the constrictive effect of the ligature. If a friend or cadaver is not available, you may
wish to practice on your leg to see if the ligature stays in place.
The vulnerable carotid artery, (large, red tube), and the vagus
nerve running parallel on its left
A ligature such as a belt or rope around the neck, or hands or
arm pressure on the neck compresses the internal carotid
artery. Apart from the direct restriction of blood to the brain
there are two other significant responses produced by pressing
on the neck:
1.) Pressing on the carotid arteries also presses
on baroreceptors. These bodies then
cause vasodilatation (dilation (widening) of the blood
vessels) in the brain leading to insufficient blood to
perfuse the brain with oxygen and maintain
consciousness.
1.) A message is also sent via the vagus nerve to the
main pacemaker of the heart to decrease the rate and volume
of the heartbeat, typically by a third.[7] In some cases there is
evidence that this may escalate into asystole, a form of cardiac
arrest that is difficult to treat.[8] There is a dissenting view on the full extent how and when a person
reaches a stage of permanent injury, but it is agreed[by whom?] that pressure on the vagus nerve causes
changes to pulse rate and blood pressure and is dangerous in cases ofcarotid sinus hypersensitivityThis
method is responsible for most, but not all, of the reported fatalities.
The method is especially dangerous when practiced alone. Involuntary movements can lead to head
trauma and other injuries. If standing, loss of consciousness can result in substantial head trauma through
falling. In the event that consciousness is not immediately regained, medical help cannot be sought by a
third party, observer, or friend. If the administration of CPR or basic life support is needed due to
respiratory or cardiac arrest, help would not be available or quickly summonable when unconscious or not
breathing. Also this act could be mistaken for suicide when practiced alone, but accidentally observed by a
stranger, to whom the motivation behind the apparent 'strangulation' is not known.
Der Karotis-Sinus-Reflex lässt sich durch Druck auf die Halsschlagader im Bereich der Karotisgabel
auslösen. An dieser Gabelung sitzen Sensoren, die den Blutdruck messen. Bei Druck oder Schlag auf diese
Stelle senken sie Blutdruck und Pulsfrequenz, weil sie den erhöhten Blutdruck an dieser Stelle fälschlich als
erhörhten Blutdruck im ganzen Körper interpretieren. Bei Menschen mit hyperaktivem Karotis-SinusReflex kann das sogenannte Karotis-Sinus-Syndrom zu kurzer Bewusstlosigkeit und zum vorübergehenden
Aussetzen des Herzschlags führen. Bei diesen Personen kann das Karotis-Sinus-Syndrom unter Umständen
bereits durch ein enges Halsband, einen engen Kragen oder Drehen des Kopfes ausgelöst werden.
"Wenn der äußere Druck gegen den Hals und den Karotissinus nur gering ist, wird in der Regel die
Herztätigkeit solange gedrosselt, wie der Druck anh#lt. Danach stellt sich das Regulationssystem wieder
auf ursprüngliche Werte ein, die Herztätigkeit erholt sich. Im Gegensatz dazu stellen eine Verletzung der
Karotissinuswand und vermutlich die intramuralen Blutaustritte einen bleibenden Reiz für die
Nervenrezeptoren dar, der über den Traumatisierungsmoment hinaus anhält, selbst wenn der äußere
mechanische Einfluss nicht mehr wirkt. Die posttraumatische Persistenz der Erregung der
Pressorezeptoren scheint somit entscheidend für die Aufrechterhaltung des Reflexgeschehens zu sein und
verhindert damit die spontane Erholung der reflektorisch ausgelösten Bradykardie oder Asystolie bzw. der
peripheren Vasodilatation mit Kreislaufkollaps, sodass der Todeseintritt die unmittelbare Folge
ist."(SMZ89)
Lokaler Sauerstoffmangel im Gehirn ist in der Regel für den Tod beim Erhängen verantwortlich. Die
Karotisarterien lassen sich je nach Art und Plazierung des Strangs bereits durch eine Zugwirkung von 3,5
bis 5 kg verschließen. Die Vertebralarterien machen zwar wegen ihrer geschützteren Lage erst ab etwa 15
bis 30 kg dicht, können aber allein keine ausreichende Sauerstoffversorgung des Gehirns gewährleisten.
Unterbricht man die Blutversorgung des Gehirns durch Abdrücken der Halsarterien vollständig, kommt es
nach etwa zehn Sekunden zur Bewusstlosigkeit; nach spätestens drei Minuten wird das Gehirn irreversibel
geschädigt.
Wird das Gehirn länger als drei bis fünf Minuten nicht ausreichend durchblutet, kommt es zu
Schädigungen, die selbst noch Tage oder Wochen später zum Tod führen können.
Selbst wenn die Sauerstoffversorgung des Gehirns nach kurzer Zeit wiederhergestellt wird, wird das
Gehirn aus verschiedenen Gründen nicht unbedingt sofort wieder ausreichend durchblutet.
Bei kompletter Verlegung der Atemwege kommt es innerhalb von einer halben Minute zur Dyspnoe, nach
1-2 Minuten zur Bewußtlosigkeit und zum Auftreten von Krämpfen, schließlich zur Schnappatmung.
Irreversible Schädigungen des Gehirns sind nach 8-10 Minuten zu erwarten. Der Herzschlag kann noch für
eine Viertelstunde feststellbar sein.
Der kritische Spielraum zwischen dem Zeitpunkt, zu dem man bemerkt, dass es jetzt wohl langsam
gefährlich wird und dem Zeitpunkt, zu dem man das Bewusstsein verliert, beträgt im günstigsten Fall
wenige Sekunden. Wenn diese wenigen Sekunden kurz vor dem Orgasmus liegen, neigt man zu einer
ausgesprochen liberalen Risikoeinschätzung. Bewusstlosigkeit kann aber auch ohne jede Vorwarnung
eintreten.
"Bei mehr seitlichem Druck auf den Hals - nach Art des Carotid-sleeper - tritt innerhalb von 3-15 s
Bewusstlosigkeit ein. Der erforderliche Druck ist relativ gering.
Wird die Halskompression unmittelbar nach dem Eintritt der Bewusstlosigkeit gelockert, so erwacht das
Opfer innerhalb der nächsten 15-20 s aus der Bewusstlosigkeit. Innerhalb der bewusstlosen Phase kommt
es zu sehr unterschiedlich ausgeprägten, mehr oder weniger generalisierten tonischen und klonischen
Krämpfen.
Betritt die Kompression mehr die Vorderhalsregion - nach Art des Bar-arm-control - so dauert es bis zum
Eintreten der Bewusstlosigkeit regelmäßig etwas länger (etwa die doppelte Zeit im Vergleich zur seitlichen
Halskompression); auch die Zeitdauer bis zum Wiedererwachen aus der Bewusstlosigkeit ist verlängert.
Nach Abdrücken der Halsschlagadern über einen Zeitraum von 100 s haben die Versuchspersonen
innerhalb von 30-40 s das Bewusstsein wiedererlangt und konnten etwa 2-3 min später wieder
herumlaufen. Auch unter diesen Versuchsbedingungen traten während der Bewusstlosigkeit Krämpfe auf,
die allerdings nicht immer generalisiert und nicht immer sehr deutlich waren." (DPM90)
"Der tödliche Ausgang setzt voraus, dass die Halskompression nach Eintritt der Bewusstlosigkeit noch
längere Zeit (bei gesunden jungen Menschen mindestens 2-3 min) aufrechterhalten bleibt." (DPM90)
Initially it was ideal, I lost conciousness in about ten seconds, however, something happened and my feet
came to the ground and the rope got slack and I came back to - in a panic. By the way, I had a
rope tied to a necktie tied to a doorknob. After so many attempts I was weak and tired. I took some time
to regain my composure. When I went back to my apartment I suspended myself again but this time
the trauma of the failed attempts hindered me. After about five seconds I knew that I had between three
and ten seconds to change my mind and I panicked again. I did not have my hands bound so I pulled the
rope from over the door as I was losing conciousness. When I came to on my bedroom floor I was
delirious. I started kicking and flailing around. When I tried to get up and walk away the rope reminded me
what was going on. I took it off and that would be the last time I made an attempt. I was too shaken and
traumatized (for lack of a better word) to try again.
Yesterday I read this and started practicing some choking. I could find both arteries of both side, and
pressing them was fairly easy.
The problem is there wasn't much of an effect; I even took 2 minutes with no pause pressing it really hard.
All I got was red-eyes and MAYBE a slightly bit of dizziness, but nothing much. I thought this method would
knock you unconscious (not dead, unconscious) after 7 or 15 seconds, but that certainly wasn't my case.
The times I've tried pressing the arteries, I've also gotten a feeling as if the "volume" of everything is being
turned down, but it doesn't
get as far as to say I can't hear anything, it's just notably more silent. Also, my heartbeat rate is pretty
quiet/low when I let go off.
Veins are lower pressure than arteries, patekial hemmoraging (red eyes) only happens when a vein is
blocked by strangling (higher pressure blood from the arteries can't drain, pressure backs up, andthe small
veins in the whites of your eyes burst) point is, a tourniqet on veins won't work as well as on arteries, and
nowadays is only mainly used on veins....
1. In a slouched position, cable positioned comfortable like a necktie being pulled towards the Adam's
apple.
2. Knot placed slightly to one side so that it ends up infront of you at when at maximum constriction.
3. IMPORTANT: As you apply force to tighten the knot. Put your hand on the knot and push it, guiding the
cable to a perfect seal-You want to make sure there is no gap between your neck and the knot and no slack.(imagine trying to
choke yourself with a Windsor tie knot)
I used a leather glove as padding on the windpipe.
Even though it might not be necessary for protection from the force, I found the cable likely to pinch you
when tightening the knot on top of your skin.
Prepare the towel and insert my head, sit down on the floor and shuffle in to position.
1st time I tighten the cable I slightly choke, loosen up and have to swallow a couple of times.
2nd time there's that tingling sensation, sit up again after only a few seconds, all set.
3rd time this is it, take a last few breaths and down I go.
Feet begin tingling, hands tingling too, lips start to go numb quickly spreading from the mouth area it feels
cold.
Thoughts of everything I wish I had done and accomplished in life suddenly rush to mind.
I begin to panic and regret the decision, I throw open my eyes but it's almost completely dark.
I claw for the cord, manage to get upright and proceed to loosen it as fast as I possibly can.
The time frame was probably only 7-8 seconds but felt like it could have been the double.
It felt almost unreal, the overwhelming desire to live.
As my vision returned I folded my hands over my face trying to comprehend what just happened.
At no point during experimenting did this happen not even during the longer 20 second full suspension
tests.I guess this is what all those people felt who jumped bridges and lived to tell the tale.
->>> working from >>2561(me)'s previous findings:
the angle of pull is important, kneeling/standing having it pull your jaw upwards will only cause pain (I
tried, at 150 lbs it wont choke you out)
by what I assume is constriction of the jugular but little else causing you to feel like your head is about to
explode.
hence why you see autoerotic asphyxiation deaths where people are standing close to level with the
anchor point in closets etc, causing a lower angle gives a better utilization of the force across the neck
unintentionally making them pass out.
I have attached a graphic depicting exactly how it was set up,
mind you it takes 2-3 seconds before the tingling starts, but when you start to go, you go fast!