Experts in domestic violence response warn that certain specific behaviours indicate a significantly higher risk of serious harm or even death. One of the most dangerous warning signs is non-fatal strangulation.Non-fatal strangulation occurs when a perpetrator intentionally restricts a victim’s breathing or blood flow to the brain, often by applying pressure to the neck, using their hands, placing the victim in a headlock or otherwise obstructing the airway.Although the victim survives the incident, it is widely recognised as a major predictor of future lethal violence and is often used by perpetrators as a form of control and intimidation.Very little pressure is needed to cause serious harm. As little as 4.4 pounds per square inch (psi) applied to the jugular vein can interrupt blood flow to the brain and cause loss of consciousness. To put this into perspective, it takes about 5 psi to crack an egg, while an average male handshake can produce 80–100 psi of pressure.The effects can occur quickly. Loss of consciousness may occur in as little as 6.8 seconds, while 15 seconds can lead to bladder incontinence and 30 seconds may cause bowel incontinence.Strangulation may leave little or no visible injuries, which makes it difficult to identify. Possible signs include bruising or marks on the neck, red spots around the eyes, swelling of the lips or face and scratches. Victims may also experience symptoms such as difficulty breathing, hoarseness, confusion, ringing in the ears or neck and chest pain.Research shows that victims who have experienced strangulation are around seven times more likely to later be killed by the same perpetrator. The SafeLives evaluation of the MARAM process in Malta and Gozo also highlighted the seriousness of this risk factor, finding that 17 of the 33 cases reviewed involved incidents or a history of non-fatal strangulation.Because symptoms can appear hours or even days later, victims are strongly encouraged to seek medical attention immediately if strangulation is suspected.Who to contact:Emergency Services 112The number to call for all emergency services in Malta (ambulance, fire and police) is 112.Support Line 179 Call 179 to report child abuse for assistance on domestic violence, homelessness, suicidal tendencies, marital and/or family problems, loneliness, emotional difficulties, behavioural problems, depression and other mental health issues, human trafficking, substance abuse and gambling.Gender Based Domestic Violence 22942717/2777National Support Line For Victims Of Crime 116006Victim Support Agency helpline is available 24/7 (Incl. Public Holidays)1579 Mental Health HelplineThe 1579 Mental Health Helpline is a 24hr national telephone helpline, providing immediate and free emotional support, advice and practical guidance for anyone in need.Women’s Rights Foundation Freephone:- 80062149 Call the helpline 80062149 for free legal advice. Their experienced and qualified lawyers will answer your queries to the best of their abilities and inform you about your rights.•