Aufderheide T P, Aprahamian C, Mateer J R, Rudnick E, Manchester E M, Lawrence S W, Olson D W, Hargarten S W
Division of Emergency Medicine, Medical College of Wisconsin, Milwaukee.
Ann Emerg Med. 1994 Nov;24(5):879-84. doi: 10.1016/s0196-0644(94)70206-3.
To determine the incidence, demographics, clinical indicators of survival, and frequency of cervical-spine fractures to define appropriate emergency airway management in hanging victims.
Medical examiner records, paramedic reports, and emergency department and hospital medical records were reviewed retrospectively for the period January 1, 1978, to January 1, 1990.
Urban paramedic system with nine receiving hospitals.
A total of 160,724 medical examiner and paramedic records were reviewed to identify a total study population of 306 hanging victims. One hundred eighty-two victims (59%) were found dead at the scene, and the emergency medical system was not notified. An additional 57 (19%) were seen by paramedics and declared dead at the scene. Sixty-seven (22%) were treated and transported to nine receiving EDs; 39 of these 67 received oral or nasal endotracheal intubation.
The incidence of hanging was 0.19% of all medical examiner cases and paramedic runs during the 12-year study. Those hanging victims who survived to receive paramedic transport and treatment by physicians were typically male and attempted suicidal hanging in a public place (most frequently jail) with available bedding or clothes. No hanging victim treated and transported by paramedics had documentation of cervical-spine or spinal cord injury.
In nonjudicial hanging victims seen by paramedics and transported to an ED, cervical-spine injury is rare. Cerebral hypoxia rather than spinal cord injury is the probable cause of death and should be the primary concern in treatment of this patient population. Following external stabilization of the neck, nasal or oral endotracheal intubation is appropriate emergency airway management in hanging victims.
确定上吊受害者颈椎骨折的发生率、人口统计学特征、生存的临床指标及频率，以明确合适的紧急气道管理方法。
回顾性分析1978年1月1日至1990年1月1日期间的法医记录、护理人员报告以及急诊科和医院的病历。
拥有九家接收医院的城市护理人员系统。
共查阅了160,724份法医和护理人员记录，以确定306名上吊受害者的总研究人群。182名受害者（59%）在现场被发现死亡，未通知紧急医疗系统。另有57名（19%）被护理人员诊治并在现场宣布死亡。67名（22%）接受治疗并被转运至九家接收急诊科；这67名中的39名接受了口腔或鼻腔气管插管。
在为期12年的研究中，上吊发生率占所有法医病例和护理人员出诊的0.19%。那些存活下来并由护理人员转运至医生处治疗的上吊受害者通常为男性，在公共场所（最常见于监狱）试图自杀性上吊，现场有可用的被褥或衣物。没有一名接受护理人员治疗并转运的上吊受害者有颈椎或脊髓损伤的记录。
在被护理人员诊治并转运至急诊科的非司法上吊受害者中，颈椎损伤很少见。脑缺氧而非脊髓损伤可能是死亡原因，应是该患者群体治疗中的主要关注点。在颈部进行外部固定后，鼻腔或口腔气管插管是上吊受害者合适的紧急气道管理方法。
