2

Sorry if my question is too silly or is in the wrong place.

How soon will a person die if they are hung upside down?

  • Probably after a few days without water. Or what do you expect them to die from? – Narusan Sep 19 '18 at 19:08
  • I don't think this is in scope for healthsciences. there's plenty of data from crucifixions if you have this morbid interest. – Graham Chiu Sep 19 '18 at 20:21
  • Assuming adequate food and water were provided, I would expect old age to be the cause of death. – Carey Gregory Sep 19 '18 at 22:22
  • The range from a few hours to a day, The mechanism of death is cardiac or pulmonary insufficiency, or a combination of both. How much time it will take depends on the state of health. – Usia Sep 22 '18 at 7:56
4

This is an interesting research question from both pathophysiological and historical perspectives:

"Upside-down death - the pathophysiology of inversion." Kirsty Andrews. Pathology. 2014.

Historically, deaths occurring in a head-down position were generally associated with inverted suspension inflicted upon the victim as a form of torture. In the current day, deaths occurring due to an inverted body position are rare and are usually the result of freak accidents which often attract media attention due to the unusual nature of the death. Occasionally an element of inverted suspension is present in deaths occurring in motor vehicle incidents when the vehicle rolls, coming to rest on its roof with the unconscious victim left suspended upside-down by the seat belt.


Early research indicated that inversion-related death would take "some hours" in healthy individuals.

"Death in a head-down position." Burkhard Madea. Forensic Science International. 1993.

Dying in a head-down position is rare and autopsy may reveal no morphological findings which explain the cause of death sufficiently. Functional changes, mainly postural changes of circulation must be considered to explain the cause of death.

Case histories on deaths in a head-down position are rare, but the problem may be of increasing interest again in connection with torture and the forensic pathologist may be asked how long will it take to die in this position. From the limited experience of some recent case histories and the experimental investigations of Wilkins et al., it can only be said that in healthy persons it may take some hours.


In unhealthy individuals (even adolescents), inversion-related death can be hastened by obesity and cardiovascular or pulmonary disease:

"Positional asphyxia in rollover vehicular incidents." Angela Martin et al. Injury Extra. 2010.

A 16-year-old driver with a body mass index (BMI) of 60.8 died after a motor vehicle collision when the vehicle went off the road and flipped over... prior to extrication by emergency medicine personnel he became less and less conscious and eventually became unresponsive. He was suspended in an inverted position for approximately 15 min total. He was pronounced dead at the scene.

Examination of the body at autopsy showed that the approximately 400 pound adolescent had rare petechiae of the conjunctivae bilaterally. The ears, nose, and lips were congested with florid facial petechiae. Internally, the lungs were markedly congested and air-filled... The cause of death was deemed to be positional asphyxia due to the prolonged suspension of the decedent in an inverted position, with a contributing factor of morbid obesity. The manner of death was accident.


Finally, an entire chapter of Forensic Pathology Reviews Volume 3 is devoted to this topic (emphasis mine):

"Death in a Head-Down Position." Achim Th. Schäfer. Forensic Pathology Reviews. 2005.

Based on these cases, it is observed that elderly people, and in particular elderly with preexisting cardiovascular diseases, seem to be more prone to death in a head-down position than others. This suggests that final heart failure is the cause of death rather than cerebral or pulmonary dysfunction. Results from human and animal experiments and observations under true and simulated microgravitational conditions confirm this assumption, suggesting that a prolonged, markedly elevated burden of work for the heart because of increased volume load in an inverted body position eventually leads to death by heart failure. Other mechanisms, such as suffocation (“positional asphyxia”), reduced blood reflux to the heart attributable to vanishing of blood in the venous system, decreased oxygen supply to the brain after reduced arteriovenous pressure difference, and carotid sinus or baroreceptor reflexes, as well as other factors, seem to play only a minor role, if any, in deaths in head-down position.

  • I'm skeptical that a healthy individual would die in a matter of hours or even days. The vague nature of the assertion and lack of supporting sources makes it particularly unconvincing. – Carey Gregory Sep 22 '18 at 22:23
  • As is mentioned in the linked chapter from Forensic Pathology Reviews, the conclusion I emphasized was drawn from 10 well-documented case studies (not exactly "vague" or a "lack of supporting sources"). Each case study is itself a publication from a peer-reviewed journal. I'm happy to share the chapter with you if you'd care to read it. Ages of the "head-down deceased" in the case studies range from 11 months to 85 years and confounding health factors aren't present in all of the cases. The chapter also cites numerous animal models and human microgravity models that draw the same conclusion. – Bruce Kirkpatrick Sep 22 '18 at 22:30
  • The final paragraph of the chapter's discussion reads: "Thus, it appears that death in a head-down position is a death of gradual (occasionally sudden) heart failure and not a kind of cerebral death or death by suffocation ("asphyxia"). Of course, asphyxia should be discussed as an additional factor influencing lethal outcome in cases where the victim is caught in very tight openings or similar structures that prevent proper breathing by thorax compression. However, asphyxia should not generally be assumed in all cases of head-down deaths." – Bruce Kirkpatrick Sep 22 '18 at 22:31
  • I can only see the abstract of that article so the details you describe aren't visible to me. – Carey Gregory Sep 23 '18 at 2:35
  • @CareyGregory Your unsubstantiated doubt led me to assume that you don’t have institutional access, which is why I offered to share the chapter with you. As with any good abstract, the methods are included in what is freely available: “This chapter examines 10 cases in which the deceased was found in a head-down position.” Regardless, specific details aren’t necessary for presenting convincing evidence that being upside down isn’t conducive to staying alive long-term (on the order of ~hours in healthy people). – Bruce Kirkpatrick Sep 23 '18 at 6:01

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