The emergency department management of near-hanging victims.

A 7-year retrospective review was performed to assess the complications of near-hangings injuries. Thirty-nine cases of near hanging were seen during this period. There were no hanging drops greater than 5 feet and no cervical spine fractures. One patient required intubation for soft tissue swelling. The adult respiratory distress syndrome (ARDS) occurred in three patients. All victims with field Glasgow Coma Scale levels >3, and three of eight with GCS = 3 survived to discharge with a normal mental status. We conclude that aggressive resuscitation and treatment of postanoxic brain injury is indicated even in patients without evident neurologic function in the field, as full recovery may still occur. Cervical spine fractures have not been reported in near-hanging victims and should only be considered if there is a possibility of a several foot drop or if a focal neurologic deficit is present. Injury to the anterior soft tissues of the neck may cause respiratory obstruction. Close attention to the development of pulmonary complications is required.