[directive] Introduction  This Directive establishes the framework for the creation of Breathing/Blood flow Restriction Event: Advocacy, Treatment, Help and Empowerment (BREATHE)  Teams in each county to respond to crimes of nonfatal strangulation and smothering statewide.  While this Directive is focused on offenses of strangulation and/or smothering against a person who is a domestic violence victim, anyone who survives a strangulation or smothering assault will be afforded access to BREATHE Team services.  Strangulation is one of the most lethal forms of domestic violence and correlates, approximately, to a 750 percent increased risk of homicide of the domestic violence victim by the offender.1  Individuals with a history of strangling intimate partners have been linked to being perpetrators in officer-involved critical incidents, intentional line of duty homicides, and mass murders.2  Many victims of strangulation exhibit no visible signs of injuries, but because of the trauma inflicted, may sustain life-threatening internal injuries, including traumatic brain injury, damage to carotid arteries, stroke, and/or permanent visual impairment.  Even when victims exhibit visible injuries associated with strangulation, the injuries may appear minor and limited to the area applied.3 of the body where pressure was Forensic Nurse Examiners (FNEs) are specifically [...] et al., Non-fatal Strangulation is an Important Risk Factor for Homicide of Women, 35 J. of 1 Emergency Med. 329, 332 (2008).  [...] & [...], Assaults, CAL.  2  Introduction and Overview of Strangulation and Suffocation in DIST.  ATT’YS ASS’N, INVESTIGATION PROSECUTION STRANGULATION  CASES 11, 13 (2020), available at AND OF https://www.familyjusticecenter.org/wp-content/uploads/2020/09/Strangulation_2020-Online-Version.pdf.  [...] et al., Cases, THE INVESTIGATION  PROSECUTION  3  Investigating Strangulation in AND OF August 21, 2023  Page 2 trained to evaluate patients who have reported strangulation and/or smothering victimization.  FNEs utilize specialized training, techniques, and equipment to gather samples, specimens and photographs that may be used in the investigation and/or prosecution of these cases.  As a result, forensic medical examinations of strangled and/or smothered victims can provide critical, life- saving medical services as well as preserve potential evidence for future prosecution.  Several counties in New Jersey have already developed and implemented procedures for a strangulation and smothering response team to include a qualified FNE performing a forensic medical exam, a law enforcement officer, and a victim advocate.  This Directive builds on the great work already accomplished and directs the expansion of these services to the entire state.  This Directive will also set forth clear parameters that will help establish better emergency care to victims of these crimes and improve the quality of forensic evidence and information collected during these investigations for future prosecution.  Therefore, pursuant to the authority granted to me under the New Jersey Constitution and the Criminal Justice Act of 1970, N.J.S.A. 52:17B-97 to -117, which provides for the general supervision of criminal justice by the Attorney General as chief law enforcement officer of the State in order to secure the benefits of a uniform and efficient enforcement of the criminal law and the administration of criminal justice throughout the State, I hereby direct all law enforcement and prosecuting agencies operating under the authority of the laws of the State of New Jersey to implement and comply with the directives outlined below when responding to or otherwise handling any matters related to offenses of nonfatal strangulation and smothering under N.J.S.A. 2C:12-1.