Medical Personnel Training


Domestic Violence and Strangulation Training for Medical Staff

Domestic Violence: The Incident, the Victim, and the Abuser


Problem Statement: 1 in 3 women and 1 in 4 men have experienced some form of physical violence by an intimate partner in their lifetime[i].  “Our study proved it – most victims of strangulation will not have visible external injuries. The lack of visible injuries and the lack of training caused the criminal justice system to minimize strangulation. We failed victims. But now we know – strangulation has serious, immediate and long-term health consequences.” Gael Strack, Esq., CEO of Training Institute on Strangulation Prevention.

Currently in Ohio, strangulation is not a felony. “Women at high risk, up to 68 percent will experience near-fatal strangulation by their partner. Loss of consciousness can occur within 5 to 10 minutes; death within minutes.”  “Only half of victims have visible injuries, and of these, only 15 percent could be photographed.” The most common visible injuries are neck bruising and so-called “petechiae spots,” which show up on the face, scalp, mouth, earlobes, eyelids, and eyeballs of choked victims. Choking also causes damage to the victim’s throat, making breathing, swallowing, coughing, and talking difficult. Infrared forensic cameras can document the tissue damage in the throat.  Death can occur days or weeks after the attack due to carotid artery dissection and respiratory complications such as pneumonia, acute respiratory distress syndrome (ARDS), and the risk of blood clots traveling to the brain (embolization).[ii]

Medical training for the identification of domestic violence injuries, including strangulation, is often overlooked, and not included in core training. Statistics show a link between domestic violence/strangulation and mass killers.  “Research has now made clear that when a man puts his hands around a woman, he has just raised his hand and said, “I’m a killer.” They are more likely to kill police officers, to kill children, and to later kill their partners. So, when you hear “He choked me”, now we know you are the edge of a homicide.” – Casey Gwinn, Esq., President of Alliance for HOPE International and Co-Director of Training Institute on Strangulation Prevention.  It is crucial for Law Enforcement Officers to understand the link between strangulation and murderers.

The July 2017 CDC report states that key intervention in ending the public health epidemic of domestic violence is healthcare workers screening.  A women who talks to her healthcare providers about abuse it 2.6 times more likely to leave her abuser.


Project Description:  Our training program provides healthcare workers an in depth look at domestic violence and strangulation.  It looks at the domestic violence incident, a conditioned victim, and a malignant narcissist.  The training provides a close look at a local strangulation case study, her long-term consequences, and her personal testimony.  We discuss medical assessment, proper photography techniques, and key documentation components. We provide the providers with a look at the prehospital care a victim receives before they reach a medical facility.  We inform healthcare workers with a look at the legal system and what to expect from the officer, prosecutor, and detective.  We provide attendees with assessment tools to take back to their facilities.  We provide attendees with a real life look at local and state policies regarding strangulation and domestic violence, visit   The best way for healthcare workers to be a voice for their patient is to better understand the dynamics of domestic violence and strangulation.  This program gives them that.


Goals and Objectives: 

  • Attendees can apply learned strangulation investigation tools and picture techniques immediately after training and be better equipped for on stand testimonies.
  • That attendees can immediately recognize signs of strangulation and be more alert for the non-visible signs/symptoms.
  • That in our 1 year follow up every attendee can report that they have used the information we have provided in each domestic violence case became a part of.
  • That on each domestic violence case, attendees are better equipped to immediately recognize the potential scene safety concerns for victims, themselves, and community members.
  • That attendees can recognize the conditioned victim and to better understand different ways to provide support and treatment.
  • That attendees are more empathetic to victims while understanding the patterns that most victims follow.
  • That attendees have a better understanding of domestic violence incidents, abusers, and victims and confidently handle them.
  • That attendees can confidently document a domestic abuse and/or strangulation case.

[i] Black, M.C., Basile, K.C., Breiding, M.J., Smith, S.G., Walters, M.L., Merrick, M.T., Chen, J., & Stevens, M. (2011). The national intimate partner and sexual violence survey: 2010 summary report.  Retrieved from

[ii] Dr. Steve Albrecht Psychology Today © 1991-2017 Sussex Publishers, LLC | © 2002-2017 Sussex Directories, Inc.



Follow the link below for a printable copy of our Medical Personnel Training flyer:
DV Medical Staff flyer