Transcript Chokes and Strangulations

Chokes and Strangulations
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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:
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Chokes technically refer to the constriction or
blockage of the windpipe, which prevents breathing.
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Strangulation technically means compression of the
arteries to prevent blood from reaching the brain.
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In most Martial Arts, these terms are used
interchangeably.
Blood vs Air Restrictions
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1. "Blood" chokes – Compression of arteries ( & veins ) in
one or both side(s) of Neck.
NOTE: No pain should be felt!!
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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.
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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?
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Quickly !!
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If the carotid artery hold is properly applied,
unconsciousness occurs in approximately 10 seconds (814 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.
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Shock, reflex action initiated on the receptor organ in the
carotid sinus, can decrease this time to < 2 seconds
HOW?
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.
HOW?
Nami Juji-Jime
(Thumb Inside)
Gyaku Juji-Jime
Ryote Jime
(Thumbs pressed In)
Kataha Jime
Okuri Eri Jime
Maximum effect,
Minimum effort
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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
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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
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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
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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.
References:
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January 1996 edition of Judo Trends Magazine
© 1995/2005 by Neil Ohlenkamp, JudoInfo.com,
http://www.bestjudo.com/article1.shtml
Deaths Allegedly Caused by the Use of "Choke Holds"
(Shime-Waza) - by E. K. Koiwai, M.D.
Emergency Care for Choke Holds - John Boulay
http://www.judoinfo.com/chokes.htm = pictures
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recognised and appreciated: I hope that the original authors
realise that their material was used as it represented the best
of this topic on the ‘net. However, I will remove your work if
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