Asphyxial deaths: near-hanging management: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Asphyxial deaths: near-hanging management

Sample item

A 30-year-old man is cut down from a failed hanging attempt, has GCS 8, noisy breathing and bruising of the neck. What is the first priority?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Secure the airway with in-line cervical spine immobilisation

In near-hanging, airway, breathing and cervical spine are the first priorities, since laryngeal injury, oedema and C-spine fracture may coexist and hypoxia drives outcome. Intubation with manual in-line stabilisation is done, followed by imaging and monitoring for pulmonary oedema. Psychiatric assessment follows stabilisation.

Option by option

  • A. Immediate CT head before anything else

    Imaging is done after the airway is secured.

  • B. Prophylactic corticosteroids for cerebral oedema

    Steroids have no established benefit and do not replace airway management.

  • C. Psychiatric review only

    Psychiatric review is necessary later but cannot come before resuscitation.

  • D. Secure the airway with in-line cervical spine immobilisation (correct)

    Correct. Airway control with spinal protection is the first step.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is D, Secure the airway with in-line cervical spine immobilisation. In near-hanging, airway, breathing and cervical spine are the first priorities, since laryngeal injury, oedema and C-spine fracture may coexist and hypoxia drives outcome.

Why is "Immediate CT head before anything else" not the answer?

Imaging is done after the airway is secured.

Why is "Prophylactic corticosteroids for cerebral oedema" not the answer?

Steroids have no established benefit and do not replace airway management.

Why is "Psychiatric review only" not the answer?

Psychiatric review is necessary later but cannot come before resuscitation.

What concept does this question test?

It tests Asphyxial deaths: near-hanging management in Forensic Medicine. Intubation with manual in-line stabilisation is done, followed by imaging and monitoring for pulmonary oedema. Psychiatric assessment follows stabilisation.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Asphyxial deaths: near-hanging management?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.