Police, prosecutors and health care workers have a new tool to deal with strangulation.

Kentucky Attorney General Russell Coleman just released a new manual that identifies signs provide strategies to prosecute cases and guides, advocates to help victims.

Strangulation happens at all ages and all socioeconomic classes, and it's an act of power and dominance from the perpetrator.

This means we're better equipped medical providers across the state with how to care for these victims.

Research has now made clear that when a man puts his hands around a woman's neck, he has just raised his hand and said, I am a killer.

He's more likely to kill police officers, to kill children, and to later kill his partner.

So when you hear he choked me, now you know you're at the edge of a homicide.

Quoting from Police Chief magazine 2022 November Strangulation is one of the most accurate predictors for the subsequent homicide of victims of domestic violence.

It's the biggest clue that a murder will take place.

As a physician.

Absence of physical exam findings and an injury that can be fatal is terrifying, even in fatal cases of strangulation.

Up to 40% may have no visible external injury of the neck, and that's because airway occlusion can occur with less force than a firm handshake, arterial compromise or blood flow to the brain can actually occur with less force.

And it takes to open a CODIS, a soda can.

That's investigation and care of patients who have experienced triangulation is incredibly important assessment for strangulation.

And children can be even more challenging, especially for those less than four years of age who are unable to verbally describe what happened.

And oftentimes, our team has to rely on their injuries to tell their story rather than their words.

Some of the signs can be seen.

Some are pate and bloodshot eyes, bruises on the neck, but many symptoms cannot be seen.

And many of these symptoms haunt victims for months to come.

For too long, our colleagues in emergency departments and our colleagues in law enforcement face too many limiting factors to investigating and successfully prosecuting these offenses.

I have investigated thousands a case of domestic and dating violence in Jefferson County before the strangulation statute in 2019.

I saw firsthand the struggles the law enforcement community across Kentucky faced when investigating strangulation.

There were no set rules, no guidance, no training.

Officers were often instructed to charge assault fourth degree, a misdemeanor or one endangerment in the first degree.

However, officers often found it difficult to articulate how the act of strangulation could create a substantial risk of death or serious physical injury.

This held especially true when there were no visible injuries, which was the case about half the time.

With this manual, law enforcement agencies across Kentucky will finally have direction when responding to and investigating strangulation.

The manual is the first toolkit to be released to address strangulation in Kentucky.