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    FAQ: Colorado Criminal – Domestic Violence Defense Law – What is Strangulation? What Does The Word Strangle Mean?

    Often in Colorado Criminal Domestic Violence cases – the police and prosecutors “overcharge” Colorado domestic violence cases by alleging a felony where there has been only a minor assault – the allegation that is typically made is that the suspect “strangled” the victim.  Here is the precise definition of strangulation – it is offered to assist those who must defend these overcharged cases.

    By Colorado Criminal Defense Lawyer – for Domestic Violence cases – H. Michael Steinberg.

    What is Strangulation

    Ten percent of homicides in the United States are attributable to strangulation. Despite this percentage, strangulation is highly misunderstood as very “minor”¨ crime. Strangulation is prevalent in domestic violence cases and sexual assaults. Victims often report this serious crime as “choking.” Law enforcement, prosecutors, the judicial, and probation often do not appreciate the serious nature of this crime.

    This webpage is an attempt to educate the judiciary about the seriousness of strangulation and how to identify and respond to a strangulation case.

    Choking vs. Strangulation

    Choking: is defined as an internal obstruction of the airway.

    Strangulation: is defined as a form of asphyxia characterized by closure of the blood vessels and air passages of the neck as a result of external pressure on the neck.

    Three Types of Strangulation


    Hangings are almost always suicides. These will not be discussed on this page.

    Manual Strangulation

    Manual strangulation is normally accomplished with one or two hands. Forearms and kneeling on a person”|s neck are also forms of manual strangulation.

    There can be different ways of manually strangling a person:

    – One handed front approach

    – Two handed front approach

    – Two handed back approach

    – Larynx with two thumbs

    – Pressure to neck with elbow or forearm, or other limb


    Ligature strangulation is accomplished with some constricting band that is tightened by force other that body weight. These can include belts, ropes, electrical cords, bedding and clothing.

    – The softer the ligature item, the less likely it will leave a ligature mark on the neck.

    – In addition, the amount of resistance offered by the victim and amount of force used also can explain the lack of ligature marks on the neck.

    Anatomy of Strangulation

    Seriousness of Strangulation

    Death or permanent impairment can occur in minutes. The brain is deprived of oxygenated blood and the body is deprived of de-oxygenated blood.

    Strangulation can cause serve pain to unconsciousness to death.

    Victims can die from strangulation injuries days later.

    Clinical Sequence of Strangulation

    The victim will lose consciousness by any one or all of the following:

    – Blocking of the carotid arteries – Depriving the brain of oxygen

    – Blocking of the jugular veins: – i. Preventing deoxygenated blood from leaving the brain

    – Closing off the airway:  – Causing the victim to be unable to breathe. – The “airway”¨ includes the hyoid bond, thyroid cartilage, and tracheal rings.

    Diagram of neck:  – Pounds of Pressure needed to cause unconsciousness

    Carotid Artery Occlusion

    Most common.

    11 lbs. of pressure for 10 seconds.

    If pressure is immediately released consciousness is regained in 10-12 seconds

    Jugular Vein Occlusion

    Second most common  –  4.4 lbs. of pressure to occlude

    Tracheal Occlusion

    Third most common.  –  33 lbs. of pressure to occlude

    Brain Death

    If strangulation persists for approximately 2-3 minutes, brain death can occur.

    Symptoms of Strangulation

    Objective and subjective symptoms of strangulation can occur with manual and ligature strangulation.

    Objective Symptoms

    Respiratory Changes:

    – Breathing Difficulties

    – Lung damage

    – Coughing up Blood (hemoptysis)

    Voice Changes (Raspy Voice)

    Visible Injuries (if present):


    Petechiae can be present throughout the face.

    Petechiae are the rupturing of capillaries (the smallest blood vessels in the body).

    -The “tiny red dots”¨ generally occur above the area of constriction.

    – The more petechiae present, generally, the greater the struggle. This indicates repeated occlusions and release of pressure.


    – Injuries are not always present.

    – Internal Injuries to the neck. Generally, medical assessment will be required to detect internal injuries.

    – Internal Bleeding

    – Laryngeal Fracture

    – Hyoid Bond Fracture

    – Thyroid Fracture

    – Closing off airway

    – Swelling may occur due to internal bleeding.

    – There may be red marks, bruises, scratches, and ligature marks present.

    – The victim may inflict injuries on their own neck in an attempt to remove the perpetrator”|s hands or the ligature item.

    – Injuries can also be caused by jewelry and/or clothing.


    – Subconjuntival Hemorrhages can be present in the eyes themselves.

    – A subconjuntival hemorrhage occurs when the capillaries rupture in the white portion of a victim’s eyes.

    – Petechiae can be present throughout the face.

    – See visible injuries to face above re definition of petechiae.

    Loss of Consciousness can occur:

    – Types of Occlusion (see diagram in anatomy of strangulation chapter):

    Carotid Artery

    Jugular Vein



    This is caused involuntarily due to sphincter incontinence.

    Urination/Defecation is a symptom that is indicative that the victim came close to dying


    Neurological Changes:

    – Seizures can also occur

    – Memory loss

    – Psychosis can be present

    Brain Death

    Other Injuries can be present from assaultive behavior:

    – Head contusions.

    – Injuries on chin.

    – Injuries on the back.

    Self defensive injuries on the perpetrator.

    Subjective Symptoms

    -Voice Changes.

    – Difficulty Swallowing “V may also be objective if third party is present immediately.

    – Breathing Difficulties “V may also be objective if third person is present immediately.

    Mental Status Changes:

    -This can include memory loss (amnesia), psychosis, and restlessness

    Suspect’s Injuries

    Defensive wounds including:

    – Scratches;

    – Bite marks; and

    – Other injuries

    Symptoms of Strangulation Are Not Always Present

    – Objective and subjective symptoms can occur with manual and ligature strangulation.

    – However, one should not always expect objective symptoms to be present.

    Common Types of Crimes that can be strangulations


    • Harassment:

    • Third Degree Assault:


    Felony Menacing:

    Deadly Weapon: In the manner it is used or intended to be used is capable of producing death or serious bodily injury:

    Any other weapon, device, instrument, material, or substance, whether animate or inanimate.

    Hands can be a “Deadly Weapon”¨ under Colorado law.

    2nd Degree Assault:

    • A person commits the crime of assault in the second degree if:

    With intent to cause bodily injury to another person, he or she causes the injury to any person by means of a deadly weapon, or

    He recklessly causes serious bodily injury to another person by means of a deadly weapon, or

    With intent to cause bodily injury to another person he causes serious bodily injury to that person.

    Definition of Serious Bodily Injury:

    Bodily injury which, either at the time of the actual injury or at a later time involves:

    1. A substantial risk of death,

    2. A substantial risk of serious permanent disfigurement,

    3. A substantial risk of protracted loss or impairment of the function of any part or organ of the body,

    4. Breaks,

    5. Fractures, or

    6. Burns of the second or third degree

    • A medical expert may be needed to substantiate the presence of Series Bodily Injury.

    * This can be a Doctor who actually examined the victim, or a Blind Strangulation Expert who can evaluate the documented injuries at a later time to determine if Serious Bodily Injury is present.

    * A Sexual Assault Nurse Examiner (SANE) may be qualified based on their training and experience to evaluate and document injuries.

    1st Degree Assault (Felony 3)

    • Heat of Passion (Felony 5)


    • Criminally Negligent Homicide (Felony 5)

    • Manslaughter (Felony 4)

    • Second Degree Murder (Felony 2)

    • Heat of Passion (Felony 3)

    • First Degree Murder (Felony 1)

    Attempted Murder

    Other Articles of Interest:

    If you found the information provided on this webpage to be helpful, please click my Plus+1 button so that others may also find it.

    H. Michael Steinberg Esq.
    Attorney and Counselor at Law
    The Colorado Criminal Defense Law Firm of H. Michael Steinberg
    A Denver, Colorado Lawyer Focused Exclusively On
    Colorado Criminal Law For Over 40 Years.
    The Edward Building
    8400 East Prentice Ave, Penthouse 1500
    Greenwood Village, Colorado, 80111
    E-Mail:  [email protected]
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