The pattern of injuries involved with domestic violence (DV) or interpersonal violence (IPV) typically involve facial injuries as the most common site of injury. A study in the Journal Of The Royal Society of Medicine showed that out of 539 adult victims of assault, 83% of all fractures, 66% of all lacerations and 53% of all hematomas were facial.
were the next most common sites of injury. Punching (72%) and kicking
(42%) were the most common methods of assault. Only six percent
involved any use of weapons. Out of all the types of inuries, those who
were kicked required the most hospitalizations. The numbers are very
similar to those found here in the U.S. as well.
This is what you're generally going to see when IPV is involved. Punching, beating, kicking and choking are classic mechanisms of injury found in domestic violence. It is mostly male against female, although females can be abusive as well.
However, the guys are bigger and stronger and when they hit, they tend to go for the face first. The face doesn't have the underlying fat and tissue to help protect it, like the rest of the body, so the injuries tend to show up quicker(and be bloodier). What we would expect to see is any of the following:
- Split lip
- Broken teeth
- Teeth imprints in the lower lip
- A lacerated eyebrow
- A red eye that will soon turn black
- Bloody nose
- Possible cheek fracture
- Abrasions on the male's knuckles from hitting the victim's teeth
- Defensive injuries on the victim
- Scratches and /or crescent shaped imprint marks from the victim's fingernails on the male's arm
Gripping and punching of the arms is next. If bruises aren't
apparent yet, there are usually red marks showing on the upper arms.
There are often imprint marks from the fingers gripping the victim's
Kicking is usually done while the victim is down. Bruising, abrasions, red marks or pattern marks from the shoe are usually observable.
Strangulation is characterized by closing off either the blood vessels to the brain or the airway or both. In DV situations, strangulation is usually from the front, done by gripping the victim's throat. On the other hand, a choke hold is done from behind with one arm going across the victim's anterior throat, compressing the carotid arteries and veins.
The usual purpose of a choke hold is to render the opponent unconscious. It's usually committed by males against other males. It's not commonly used against females, except in domestic violence situations.
"Choking is a form of power and control. When batterers attempt to strangle their victims, they are taking away their voice and preventing them from screaming for help."-- Casey Gwinn, San Diego, City Attorney.**
The choke hold frequently leaves no visible injuries. In fact, often the visible injuries are on the batterers arms, from the victim trying to break the hold by digging deeply into his arms with her fingernails.
There are four mechanisms involved with injuries from a choke hold:
- Cardiac Arrhythmia from pressure on the carotid nerve ganglia - can cause cardiac arrest and death (rare)
- Pressure on the carotid arteries obstructing blood to the brain
- Pressure on the jugular veins - preventing blood returning from the brain - causes unconsciousness, respiratory depression, and asphyxia
- Obstructing the larynx - blocking air flow to the lungs * From the IAFN Newsletter: Manual and Ligature Strangulation
It takes only 11lbs. of pressure, held bilaterally for 10 seconds, to cause the victim to become unconscious.
If applied to a person under stress during a struggle, a
strangle may make the person unconscious almost immediately, while it may take
several seconds for a calm person to pass out.**
If released, consciousness returns in about 10-20 seconds.
If held for 50 seconds, damage is usually irreversible.
Death occurs at 1-2 minutes.
Policemen are no longer allowed to use this type of restraint against a strong, violent male prisoner due to the deaths that have occurred as a result of the compression on the airway.
It takes only 4 lbs. of pressure to obstruct the jugular veins.
To make a comparison:
It takes 6 lbs. of pressure to pull the trigger of a gun.
It takes 20lbs. of pressure to pull the tab on a soda can.
This is one of the biggest problems I had with the Duke accuser's original complaint. What was the purpose? We're talking about a 150 lb. impaired woman being held in a choke hold by a very tall, athletic player weighing in at around the 200lb. mark. The alcohol is a central nervous system* depressant. The Felxeril is a central nervous system* depressant.
CNS depressants can cause respiratory depression. The compression from the choke hold not only can cause unconsciousness in about 10 seconds, but can also cause respiratory depression. She said she was fighting and it was hard for her to breathe. For how long? Logically, in my opinion, she should have fallen unconscious even before she could have been fighting.
While the choke hold may not cause visible injuries, it can cause non-visible injuries such as laryngeal injuries and swelling, Hyoid bone fractures, a hoarse or raspy voice, and trouble swallowing. Since the accuser's complaints were in the initial police report, a strangulation form should have been filled out by the SANE nurse stating what injuries were noted. This is required for all complaints of strangulation / choking if evidence is found*. I would also have expected xrays to be done to check for internal injuries.
What I find interesting is not only the accuser's complaints so closely resembling those usually found in Domestic violence, rather than in this type of rape, but also the fact that there doesn't appear to be any such injuries anyway. At least, I haven't read of any so far.
No bruises, abrasions, tears, split lips, black eyes, pattern marks, hoarse voice, trouble swallowing....the list goes on. I have read of neck and back pain. I've also read that she has a chronic pre-existing condition involving neck and back pain.
Too many questions. Not enough answers.