Warning: This story refers to physical and domestic abuse.
A clinic in Surrey, British Columbia, that has long served choking victims, has a dedicated clinic for those services.
“We needed a specialized clinic where this could be looked at and people could feel supported,” said nurse practitioner Hannah Varto at the Embrace Clinic, which has been providing services for choking victims since 2015.
“It gives me goose bumps even just saying that…people who have been strangled, especially women, by their domestic partner, are seven times more likely to be killed by their future partners.”
Previously a mobile clinic, Embrace has secured a permanent site across Surrey Memorial Hospital in 2021 – where, last fall, it opened the Strangulation Clinic, which they say is in recognition of the serious health and safety consequences of violent work.
The province told CBC News that it is not aware of other similar clinics in British Columbia
Usually overlooked as strangulation, experts say it has become the focus of more studies recently due to consequences such as health problems and domestic homicides.
It is the leading indicator of a future escalation of violence, according to Winston Sison, a crown attorney of 30 years and now retired.
“When you get to that point you’re in a very dangerous red zone,” he added. Strangulation is now equivalent By assault with a weapon or an assault that causes bodily harm.
In 2019, the Criminal Code addressing assault with a weapon or causing bodily harm was amended to include an additional offense of asphyxiation or suffocation. If convicted, the offender could face up to 10 years in prison.
Another criminal code dealing with sexual assault also contains a subsection, considering a similar offense of strangulation.
An analysis by Fraser Health found that from 2017 to 2022, choking occurred in 55 percent of cases among 405 intimate partner violence patients at Surrey Memorial Hospital.
According to the health authority, the hospital’s forensic nurses — who work closely with the strangulation clinic — have noticed more reports of violence since those incidents were documented in 2014, including strangulations that led to unconsciousness and loss of bowel or bladder control.
“It was helpful to consider the number of choking incidents – and the physical, emotional, social and safety-related effects we might have missed by not specifically asking about and treating choking as an existing health and safety risk,” said Fraser Health. in the email statement.
Concussion symptoms in suffocation victims
Services at the clinic include a full head and neck exam to assess injuries and vascular damage, sleep management strategies, counseling, and conversations about mental health and post-attack treatment options.
Varto says many people were surprised to learn they could suffer a traumatic brain injury from choking or blows to the head.
“What we’re seeing here is when we follow up on these patients, they have all the symptoms of a concussion” — including persistent headaches and difficulty concentrating, sleeping and remembering things, Varto said.
Last year, of the 480 patients who visited the clinic in the aftermath of recent violence, 60 percent disclosed that they had suffered suffocation, a head injury, or both while being assaulted, according to Fraser Health.
Nurse practitioner Hannah Varto explains some of the ways she assesses patients who have experienced choking.
If strangulation and concussion recur, says Paul Van Donkelar, professor of health and sciences at the University of British Columbia Okanagan and SOAR’s principal investigator, the injuries are similar to those seen in retired professional hockey or soccer players with a history of blows to the head. (Supporting survivors of abuse and brain injury through research).
“They live with these chronic effects, chronic symptoms for months to years, and the upshot is that it can potentially lead to long-term neurodegenerative disorders like dementia and Alzheimer’s disease,” he said, adding that more research is needed on brain injuries from intimate partner violence. intimate.
Barriers to accessing care
SOAR co-founder Karen Mason says strangulation victims often suffer from a lack of services, in part because violence isn’t always reported and injuries can be unseen.
The Ministry of Health says that victims may receive treatment in emergency departments and not be admitted to an inpatient bed.
Strangulation may also coincide with other attacks that leave injuries such as bruises. When victims do not disclose strangulation while seeking care, other injuries may become a focus, Fraser Health explains, adding that a lack of blood and oxygen flow to the brain during strangulation can also cause memory loss in victims.
Mason says health care workers are often unaware of brain injury caused by strangulation during intimate partner violence.
“If these professionals do not understand the nuances and complexities of an abusive relationship, and if they are not trained in trauma-informed practice, they will not be able to serve the survivor in the way she needs to be.”
The Vancouver-based Battered Women Support Services (BWSS) says it helps educate medical students about the prevalence of choking and the assessment of traumatic brain injuries.
Access to services also comes with barriers, says Angela Marie MacDougall, executive director of BWSS, as controlling partners often prevent victims from seeking care.
“This does not mean that she is free to go and get medical care,” she said, adding that it is important to work with local organizations, crisis lines and transitional homes to help people safely access medical support.
“We want to make sure she navigates safely in what could be a very deadly situation.”
Anyone 13 or older who has recently choked can book an appointment with the clinic by phone or email, or get a referral from doctors, community service providers or the police.
Discussion about this post