ICFM Magazine, January 2005
As every funeral professional knows very well, hanging can be and often is one of the most disturbing death scenes to be called to. I have seen many such cases, and it amazes me the ways in which the trauma to the head and neck can vary. Of course I am not talking about capital punishment cases here, only about accidental hangings and intentional ones (suicide).
Both accidental and intentional hanging can result in significant problems for the embalmer. But often the hanging victim can be embalmed by using a restricted cervical, injecting both left and right carotids and taking drainage from the left and right jugular veins.
The principal problem frequently found with hanged victims is blood congestion in the face and the neck. In older individuals with sclerotic arteries, complete severance of the arteries has been known to occur.
As mentioned above, the carotid approach is best in these cases. I have used a small amount (6 ounces) of a quality pre-injections fluid to assist in removing the discoloration due to the congestion of blood in the head. Following this I inject a waterless embalming solution made up of 16 ounces of a coinjection chemical, 8 ounces of a 25 index arterial fluid and 4 ounces of a humectant for rehydration of the tissues.
I sometimes will hypodermically inject a small amount of a bleaching agent, but usually the action of the preinjections chemical will suffice to handle the discoloration. After dealing with that, tie off the left common carotid artery and left internal jugular vein and start injecting the rest of the body.
In treating the cavities, be very careful to thoroughly aspirate the thorax. If the noose of the rope ruptured the circulation, there may be accumulations in the upper thorax of blood that flowed out under pressure at the moment the noose injured the arteries and veins.
When the cavities are thoroughly relieved and then treated with a quality cavity chemical, one bottle up and one bottle down, there should be no more trouble. However, as all embalmers are aware, there are no guarantees in the art of embalming, so regular monitoring of these cases is a necessity.
After several hours, a quality tissue-building injection may be introduced beneath the traumatized area where the noose did damage to properly reestablish the normal appearance of the neck, which may have been compressed by trauma. Cosmetics can generally conceal any discoloration or marks that may remain at the end of the procedure.