Asphyxial death ( In Case of Hanging)

The following procedure is in addition to what has been described under Autopsy Procedure:

Scene visit

  • Scene visit should be carried out as indicated or at least assessment should be done on basis of SOCOs report and photographs provided by investigating police officer
  • All scenes should be visited as far as possible with accompanying police.
  • In the cases of hanging, measurements from ground to the hanging point (Suspension Point), height of the support to reach the suspension point, must be documented
  • Scene must be examined for signs of violence and circumstantial evidences
  • Scene visit/assessment is always educative to give clear opinion which saves precious time of medical and investigative personnel
  • Photography should be taken before moving the body
Salivary dribbling photographed at the scene

External Examination:

  1. Examine for presence of salivary dribbling over:
    • Face
    • Neck
    • Clothing
    • Ligature material must be described with special reference:
    • Width
    • Length  
    • Presence of cut ends    
    • Description of the knots (fixed/ slip knots)
  2. The ligature mark is a very important piece of evidence, as it may reproduces the pattern and dimensions of the ligature itself.
  3. Description of ligature mark (abraded contusion) with reference
    • Color
    • Parchmentized or non-parchmentized
    • Width
    • Length
    • Direction
    • Complete/ incomplete- Encircled
    • Peri ligature injuries
  4. Distribution of hypostasis must be described and interpreted in relation to the posture
  5. Comment on the presence of petechial hemorrhages, congestion of head and neck, sub-conjunctival hemorrhages of eye
  6. In case of female, external genitalia and peri-anal region must be examined for injuries. And swab must be be collected in all suspicious case of alleged hanging.
Imprint abrasion in hanging

Internal Examination

  1. Bloodless neck dissection is carried out after evisceration of brain and thoracic block and dissect the neck structures layer by layer to note soft tissue injury.
  2. Presence or absence of neck injuries (contusions, hematoma or fractures) should be noted over
    • Soft tissue (platysma, neck muscles)
    • Blood vessels
    • Thyroid cartilage
    • Hyoid bone
    • Laryngeal cartilages
  3. Blood sample for toxicological analysis should be collected, where body found hanging, in suspicious circumstances
Reflection of skin in bloodless dissection of the neck
Para-vertebral soft tissue exposed after dissection of neck structures