Gagging combines features of smothering and choking. A gag in a victim's mouth or wrapped around the nose and mouth interferes with the ability to breathe and swallow (338). A foreign object can be inserted into the victim's mouth prior to gagging (338). Although they are usually associated with homicides (e.g., elderly robbery victim, neonaticide), gags have also been used to stifle screams by victims using a painful method of suicide (e.g., self-immolation [415]).

Fig. 60. Acute aspiration. Larynx and mainstem bronchi.

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