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ST. LOUIS (KTVI) – Strangulation is one of the most deadly forms of domestic violence, and it’s a felony in both Missouri and Illinois. However, many first responders and emergency room personnel are not trained to know what to look for.

St. Louis University Hospital forensic nurse, Kathy Howard, says it takes about 22 pounds of force to open a can of soda. It takes just 4 pounds to damage the jugular vein.

Howard became a sexual assault examiner in 2000. She collects evidence and cares for victims of rape and domestic violence as demonstrated in the video.

Howard founded the first forensic nursing program in the St. Louis area. She educates first responders about the signs and symptoms of domestic assault. She has worked with several victims who have been arrested at the scene of a domestic incident because the victim did not show any injuries.

“(The victim) may have scratched (the offender’s) arms up because (the offender’s) got (their) hands around (the victim’s) neck and so (the offender) may have the only scratches, but it was (the victim) trying to save (their) life,” Howard said.

Strangulation blocks oxygen going to the lungs and brain. According to Howard, many symptoms of strangulation get worse over time and may be fatal even 21 days after the attack.

A prolonged loss of consciousness elevates the risk of death and brain damage. Long term risks of strangulation include miscarriage, memory loss and stroke.

“Victims who are strangled during a domestic violence assault are much more likely to end up being the victim of homicide down the road,” said Howard.

According to Howard, it’s difficult to track the number of strangulation cases since only an estimated three percent of victims seek medical attention. However, statistics suggest strangulation could be a factor in as many as half of all domestic violence cases.

If you or someone you know is experiencing violence in the home, local help is available.

St. Louis Circuit Attorney’s Victim Services – (314) 622-4373
Domestic Violence & Rape Hotline – (314) 531-2003
RAINN (Rape & Abuse Hotline) – (800) 656-4673
St. Louis Regional Sexual Assault Center Hotline – (314) 531-7273 (RAPE)