CRMC receives training grant for strangulation detection, treatment

Nov. 25—CHEYENNE — A recent grant through the American Rescue Plan Act may help local nurses, law enforcement and others better detect, treat and even prevent non-fatal strangulation cases.

Barbara Horton, director of Cheyenne Regional Medical Center's Forensic Nursing Program, applied for the funds. The $7,000 grant was approved earlier this month by the Laramie County Board of Commissioners.

Strangulation is a complicated, sometimes misunderstood act, Horton told the Wyoming Tribune Eagle. This type of training aims to help medical providers, first responders and others involved in crime response ask better questions to identify strangulation events and familiarize themselves with what strangulation can look like.

"My hope is just that everyone has a better understanding of the potential lethality of strangulation, and how to ask people if anything like that has occurred," Horton said. "They teach that strangulation is the ultimate form of power and control, because you're literally taking control over the victim's next breath. It's also the best indicator of subsequent homicide of victims of domestic violence. So, it's a big deal."

Horton added that strangulation, if not immediately fatal, can sometimes still kill a person in a delayed manner.

She said people often underestimate how easily strangulation can seriously injure a person. To put it in perspective, Horton said, the average handshake between two adult men is 80 to 100 pounds of pressure. But 33 pounds of pressure is all it takes to crush someone's windpipe.

In Wyoming, "strangulation of a household member" is a felony punishable by up to 10 years in prison. Someone guilty of the offense intentionally or recklessly causes bodily injury by "applying pressure on the throat or neck" or "blocking the nose and mouth."

The Forensic Nursing Program began as a collection of SANEs, or Sexual Assault Nurse Examiners, and a few years ago "expanded into a full forensic program," Horton said. These nurses now care for victims of many types of crimes, including sexual assault, domestic violence, child abuse, elder abuse and other types of assault.

CRMC's forensic nurses have seen an increased number of strangulation cases this year, she said. There were 37 total cases that went through the hospital in 2021. So far this year, they've seen 38.

And like any crime — especially those linked to interpersonal violence or abuse — it's safe to assume these numbers are undercounts.

"Our services are completely voluntary, because some people don't want to (be examined or treated), or they may be frightened to do that, and that's completely understandable," Horton said. "A lot of people that are maybe victims of domestic violence, once they've reported something, they are at even higher risk of homicide. So, I know that we don't lay hands on probably even half the people that have gone through this."

The Forensic Nursing Program is funded by the state, but with budget cutbacks in recent years, the program has had to look elsewhere for training funding, Horton said.

The training is through Alliance for HOPE International, which Horton said offers very beneficial — though costly — in-person trainings in California, where the organization is based. The ARPA grant would pay for a digital one-day training session that doesn't place a limit on how many people can attend.

In addition to forensic nurses, Horton said she hopes to invite to the training providers throughout the hospital, first responders — including emergency medical services, local law enforcement and firefighters — members of the Laramie County District Attorney's Office, the Laramie County Coroner's Office, and Wyoming's Department of Family Services and Division of Victim Services.

She plans to set a date in March for the digital training.

Hannah Black is the Wyoming Tribune Eagle's criminal justice reporter. She can be reached at or 307-633-3128. Follow her on Twitter at @hannahcblack.