Presentation on theme: "Chokes and Strangulations How Anatomical Structure of the Neck Physiology – Blood vs. Air Restriction Positions & Structures Why Control the Individual."— Presentation transcript:
Chokes and Strangulations How Anatomical Structure of the Neck Physiology – Blood vs. Air Restriction Positions & Structures Why Control the Individual Control the Situation Finish quickly – Multiple Attackers !! When Upright / On the way to the ground / Ground Last Resort Only you will know – Legal implications
Definitions: Chokes technically refer to the constriction or blockage of the windpipe, which prevents breathing. Strangulation technically means compression of the arteries to prevent blood from reaching the brain. In most Martial Arts, these terms are used interchangeably.
Blood vs Air Restrictions 1. "Blood" chokes – Compression of arteries ( & veins ) in one or both side(s) of Neck. NOTE: No pain should be felt!! 2. "Air" chokes - chokes that attempt to stop the breathing. This choke in actual practice is generally effective due to the pain & panic involved, and not the actual cut-off of breathing. 3. "Combination" chokes - Those chokes which don't rely on either of the two above, but is rather a combination of the above two categories.
HOW? Quickly !! If the carotid artery hold is properly applied, unconsciousness occurs in approximately 10 seconds (8- 14 seconds). After release, the subject regains consciousness spontaneously in 10-20 seconds. Neck pressure of 250 mm of Hg is required to occlude carotid arteries. The amount of pressure to collapse the airway is six times greater. Shock, reflex action initiated on the receptor organ in the carotid sinus, can decrease this time to < 2 seconds
Fig 1: Anterior triangle of the neck (front view)
Fig 2: The forearm applies pressure to the left superior carotid triangle. A top view of the head is shown with the back of the head furthest from the forearm.
Maximum effect, Minimum effort Compression of the carotid arteries is desirable because it requires the least force, is the quickest acting of the choking techniques, is the most universally effective against all opponents, and it is most in keeping with the efficiency principle of all arts, "maximum effect with minimum effort." Medical tests have established that the amount of pressure needed to occlude the arteries is six times less than the pressure needed to collapse the airway. Directly stopping the blood supply to the brain also results in loss of consciousness about six times faster than indirectly reducing oxygen in the brain through restricting breathing or the flow of air to the lungs.
A&P Anatomically, the anterior cervical triangle of the neck contains the superior carotid triangle. The pressure can be applied to either side. The anterior cervical triangle is a triangle bordered by the sternocleidomastoid muscle (large neck strap muscle) laterally, the mandible jaw bone above, and medially by the cervical midline, a line drawn from the tip of the jaw to the sternal notch. Within the anterior cervical triangle, there are three smaller triangles: submandibular (submaxillary or digastric) superior carotid inferior carotid (muscular). In the technique of choking, the most important triangle is the superior carotid which contains important structures. This triangle is bordered by the stylohyoid and the posterior belly of the digastric muscle above, the anterior border of the sternocleidomastoid muscle medially. Within the superior carotid triangle are the common carotid artery and branches, the carotid bodies, internal jugular vein, vagus nerve and branches, superior laryngeal nerve, and cervical sympathetic trunk. Overlying this superior carotid triangle is only skin, superficial fascia which usually are thin although there may be an appreciable amount of subcutaneous fat. Within the superficial fascia is an exceedingly thin (paper-thin) muscle, platysma muscle, which begins in the tela subcutaneous over the upper part of the thorax, passes over the clavicle (collar bone), and runs upward and somewhat medially in the neck and across the mandible to blend with superficially located facial muscles. The platysma muscle has no very important action, but will wrinkle transversely the skin of the neck and help to open the mouth. 'This muscle does not protect the underlying vital structures. Consequently, the amount of pressure directed to the superior carotid triangle needs to be no more than 300 mm Hg to cause unconsciousness in an adult. A child can, if the choke is properly performed, without great strength "choke out" an adult twice their size.
First Aid Basic First Aid: - ABC, Unconscious Casualty Thru to CPR Unconsciousness occurs about 10 seconds after the application of an effective choke. After release, the athlete should regain consciousness in about 20 seconds. Should the athlete remain unresponsive after this period, seek medical assistance immediately. Unconsciousness in itself may be deemed a medical emergency if it is prolonged and the underlying cause is not recognized.
First Aid - Traditional Traditional resuscitation techniques include: The direct massage of the carotid triangle on the neck to open up a collapsed artery or to manually stimulate the carotid sinus. Methods of inducing or simulating breathing through massage of the chest or diaphragm, expanding and contracting the lungs. Three such methods of Kodokan Judo are Sasoi Katsu, the inductive method, Eri Katsu, the lapel method, and So Katsu, the composite method. The Kodokan teaches Sasoi Katsu with the patient sitting before you. From behind, bend your right knee and place the kneecap against the patient's spine. Spread your fingers and place your hands on his or her lower chest, hooking your fingers under the lower ribs. Pull back as if opening the ribs to either side, put your weight on the shoulders to bend the body back, and press with your right knee. This will draw air into the lungs. When the ribs have opened as far as they will go, release them. Air will be exhaled from the lungs. Repeat the process slowly and regularly. For traditional Eri Katsu kneel to the right of the victim and support his or her upper body with your left arm around the shoulder. Put the palm of your right hand on the abdomen, just above the navel, and press up against the solar plexus or pit of the stomach. This will cause the diaphragm to rise, expelling air from the lungs. Reinforce the action by bending the upper body forward with your left arm. Gently release your pressure to allow air to enter the lungs. Repeat this procedure until respiration is restored. For So Katsu lay the victim on his or her back and kneel astride the hips. Place your hands, fingers spread apart and pointing toward his or her head, on the bottom of the rib cage. Lean forward and press against the ribs to make him or her exhale, then relax the pressure. Repeat this procedure, rocking forward and back, until the victim can breathe without assistance. Similarly this can be done with the victim on his stomach.