Neck Hold Techniques: A Cop's Perspective Part 2
By Al Arsenault
Sealing the Breath
Sealing the breath refers to the act of inhibiting air from entering the lungs (respiratory restraint). This can be achieved through several means. The solar plexus can be struck for instance, in order to paralyze the diaphragm, thereby impairing the mechanics of breathing. If the diaphragm does not regain function prior to the air being used up in the lungs, unconsciousness results. The other way to seal the breath is to use 'choking' techniques, widely used in ground fighting because they can quickly end a fight by painful submissions. Choking techniques often employ a forearm to apply pressure across the front of the throat to close off the airway. Predatory animals instinctively go for the throat, as this is the fastest and most efficient way to subdue and kill their prey. In a street fight, the throat is a vital area in need of protection.
Neck Restraints vs. Chokes
'Lateral vascular neck restraint' refers to the act of sealing the vein and should be referred to as 'sleeper holds' or 'vascular neck restraints'. Chokes are more painful than sleepers are but they are less efficient in rendering a person unconscious. It has been estimated that it takes six times the amount of force to collapse the cricoid cartilage reinforced airway that it does to flatten the carotid artery. [[FN: Reay and Eisele, 1982, p. 255-256]] A person can remain conscious and fight back as long as there is air in the lungs (over a minute?). So painful are these chokes that a person will immediately submit or they will fight wildly, fuelled by an adrenaline dump that accompanies the 'flight or fight syndrome', in order to stop the intense pain and to save their own life from suffocation. Due to the damage that choking can do to the relatively delicate structure of the neck, the application of chokeholds should be withheld for life and death situations.
Police agencies have banned these choke holds in favor of sealing the vein techniques, although some agencies (such as the L.A.P.D.) have even banned these latter techniques as well due to a number of deaths in the 1970s and early 1980s. Death often ensued in post-arrest situations when the arrested party lapsed unnoticed into unconsciousness due to suffocation experienced from the swelling shut of the windpipe. The larynx (thyroid cartilage or Adam's apple), trachea (cricoid cartilages), and the hyoid bone (floating base of attachment for the tongue) can all be damaged using the choke hold. The consequences of rendering a struggling opponent unconscious using this relatively painful and slow-acting technique may be lethal.
Sealing the Vein
Sealing the vein refers to the class of techniques that renders a person unconscious by stemming the flow of blood to the brain. It is a much safer technique to apply but one should be properly trained before applying it, as it too has inherent dangers associated even with its proper use. It was previously thought that neck restraint worked solely because of the compression of the carotid arteries. Perhaps this class of techniques would have been more technically correct if they were labeled 'sealing the artery'. After all, the higher pressure arteries bring oxygenated blood to the brain (and all other parts of the body) whereas the lower pressure veins return the de-oxygenated blood back to the heart and lungs. But it cannot be overlooked that the blood is held mostly in the veins (60%), with smaller amounts in the arteries (25%), and the capillaries (15%). The common carotid artery and the vagus nerve lie underneath the internal jugular vein (also in the carotid sheath) that runs up the front sides of the neck. The jugular vein is more susceptible to compression than that of the smaller and more resilient carotid artery. This means that if pressure is applied to the carotid sheath, then the vein would be most readily sealed first. It would be impossible to seal the vein and not the artery, so the term sealing the vein is an appropriate one after all.
The carotid vein and artery can be accessed by pressing into the depression on either side of the larynx and trachea, just under the anterior border of the sternocleidomastoid muscle, which tends to protect this blood flow. This is a commonplace pulse palpation point where people can check their own pulses (also the standard C.P.R. pulse check site). At a point level with the tip of the Adam's apple, the carotid artery bifurcates into the internal and external carotid arteries. Just slightly above this splitting of the artery, attached to the somewhat larger (of the split pair) internal carotid artery, is found the carotid body. This chemoreceptor site monitors the level of oxygen in the blood. Low oxygen levels stimulate an increase in heart rate, blood pressure as well as the rate and depth of respiration via the carotid sinus nerve. This nerve further innervates the carotid sinus, a slight dilation within the beginning of the internal carotid artery. It is a baroreceptor site which has pressure sensitive receptors lining the walls of the carotid sinus. It, along with the vagus nerve, allows the brain to make adjustments in the rates of breathing and heart rate as to keep this pressure sensitive organ with a steady pressure of blood, regardless of the head position. It is this latter reaction to an increased pressure that slows down the circulatory system that neck restraint techniques exploit in order to render a person unconscious. The carotid sinus cannot distinguish between high blood pressure resulting from internal circulatory problems and that caused by externally applied pressure to the neck. A significant reduction of the oxygen tension (and concomitant carbon dioxide tension) in the blood would not occur until after a person has been rendered unconscious at which point, the carotid body reaction of increased heart, respiration, and blood pressure rates would help to revive the person. Some people experience 'carotid sinus hypersensitivity', the mere palpation of this spot causing a fall in blood pressure, a slowing of the heart rate, and even fainting.
It makes sense then that sealing both the carotid arteries and the jugular veins aids in a diminishment of circulation to the brain (the brain does have other, albeit relatively minor circulatory routes such as with the vertebral arteries and veins, so total blockage is not possible). The majority of the brain's blood supply (70-80%) comes from the carotid arteries and this circulation is bilateral, hence both arteries must be sealed for maximal effect. This can be accomplished by using various parts of the body such as the arms, hands or legs. Digital pressure can reduce the blood flow in the carotid arteries by 80% at most. [FN: Pressure point and Control Tactics Defensive Tactics Instructor's Manual, by Bruce Siddle, 1998, pp. 8-2].
Other methods of restraint are not as reliable, but unconsciousness can be attained. For example, circulatory restriction may also be achieved using clothing, but your opponent may not always be wearing a shirt or jacket suitable for a decent lapel grab.
Arsenault, Alan, D. Chin Na in Ground Fighting: Principles, Theory and Submission Holds for all Martial styles. Boston, YMAA Publications, 2003.
Reay Donald, T. and J.W. Eisele, "Dearth From Law Enforcement Neck Holds." The American Journal of Forensic Medicine and Pathology. Vol. 3, No. 3: 253-258, 1982.
Siddle, Bruce K. Pressure Point and Control Tactics: Defensive Tactics Instructor Manual. Millstadt: PPCT Management Systems Inc., 1999.