Denver has a longstanding commitment to a coordinated, multi-disciplinary approach in responding to domestic violence and sexual assault. Through initiatives such as the Collaborative Domestic Violence Response Team, the Sexual Assault Interagency Council, and Colorado’s first family justice center, Denver prioritizes survivor-centered practices that reduce retraumatization and improve victim safety and accountability. Central to these efforts is the Denver County Strangulation Response Protocol, which promotes a consistent, cross-sector approach to detecting, documenting, and intervening in cases involving strangulation, a high-risk, often invisible form of violence. The protocol ensures shared recognition of the lethality and prevalence of strangulation, sets clear expectations for agency roles, and emphasizes survivor education and safety planning.
Research highlights the alarming frequency and danger of nonfatal strangulation in domestic violence and sexual assault cases, with rates ranging from 68 to 80 percent of incidents, and often no visible injuries. Strangulation is second only to gunshot wounds in lethality and is a strong predictor of future homicide. Victims frequently report multiple strangulation assaults, increasing their risk of death and serious health consequences, such as traumatic brain injury. The protocol also calls attention to emerging concerns, including strangulation during consensual sex, risks to children in affected homes, and underrecognized suspicious deaths. Early and informed intervention through proper screening, documentation, and accountability is critical to preventing further violence and saving lives.
Strangulation is a strong predictor of future homicide in intimate partner violence and often lacks visible injuries, making thorough, trauma-informed investigation and symptom-based documentation essential. The Denver Police Department mandates EMS response for all reported cases and encourages forensic medical exams by specially trained SANE nurses to identify internal injuries and preserve critical evidence, supporting both victim care and successful prosecution.
EMS providers often serve as the first and only medical contact for strangulation victims, making their role critical in recognizing symptoms, educating patients about the dangers, and encouraging further medical evaluation. Proper training, separate patient assessment, thorough documentation, and transport to facilities with 24/7 Forensic Nurse Examiner (FNE) programs are essential to ensure accurate diagnosis, preserve evidence, and support the victim’s safety and recovery.
Strangulation is a common but often undisclosed form of violence in intimate partner and sexual encounters, carrying serious and sometimes delayed health risks such as brain injury, stroke, and death. Medical providers should consistently screen for strangulation, conduct thorough assessments and forensic exams when indicated, and document both physical and neurological symptoms carefully, as early recognition, imaging, and appropriate referrals can significantly impact long-term outcomes and support both patient care and legal proceedings.
Prosecutors play a critical role in holding offenders accountable for non-fatal strangulation and must be trained to recognize its medical dangers, gather appropriate evidence, and understand trauma-informed prosecution strategies, especially when victims are unable or unwilling to testify. A coordinated response between prosecutors, victim advocates, and medical professionals ensures high-risk cases are handled appropriately, with advocates providing ongoing support, facilitating medical care, and helping victims navigate the legal system safely and effectively.
Pretrial Services and Probation play key roles in managing defendants charged with strangulation by assessing risk, recommending supervision levels, and ensuring victim safety through GPS monitoring, advocacy, and coordinated response. Officers and staff must receive ongoing training on the dangers of strangulation, its health impacts, and high-risk dynamics, while victim advocates provide essential support, education, and safety planning throughout the pretrial and probation phases, ensuring that victims are informed, protected, and connected to necessary resources.
System-based and community-based advocates both play essential roles in supporting survivors of strangulation, with system-based advocates guiding victims through the legal process and community-based advocates offering confidential, ongoing support. All advocates should be trained to screen for strangulation, understand its high lethality risk, and help survivors access medical care and develop individualized safety plans. Trauma – and violence – informed care is critical to addressing the complex needs and barriers survivors may face.
The Rose Andom Center will be closed on Tuesday, March 31. We will reopen on Wednesday, April 1.
If you need support during this time, please contact the National Domestic Violence Hotline at 800-799-SAFE (7233) or SafeHouse Denver’s crisis line at 303-318-9989
Aviso de Cierre por Día Festivo
El Rose Andom Center estará cerrado el martes 31 de marzo. Volveremos a abrir el miércoles 1 de abril.
Si necesita apoyo durante este tiempo, comuníquese con la Línea Nacional de Violencia Doméstica al 800-799-SAFE (7233) o a la línea de crisis de SafeHouse Denver al 303-318-9989
