Chokes and strangles are often confused, since they both involve applying pressure the the neck. Strangles are applied to the one or both of the carotid arteries at the side of the neck. Strangles are used to reduce or stop blood flow through the arteries to cause the person to feel faint or pass out. Chokes are applied to the trachea to block the flow of air to and from the lungs.
Forensic literature says that to kill a person by interrupting blood flow to the brain, you need to hold pressure for minimum two minutes, although the person may blackout much sooner. If applied to a person under stress during a struggle, a strangle may make the person unconscious almost immediately, while it may take several seconds for a calm person to pass out. Reay and Eisele's 1983 article in the American Journal of Forensic Pathology "Death from law enforcement neck holds" states that with the Judo-derived police carotid sleeper hold, blood flow to the head is reduced by an average of 85% in approximately six seconds.
Pressure to the carotids is applied to the lateral side of the neck which the anatomists call the "carotid triangle." This triangle is formed by the midline, anteriorly (front) from the apex of the chin to the upper part of the sternum (breast bone), superiorly (above) by the line formed by the lower border of the mandible (lower jaw bone) and posteriorly (behind) by the anterior border of the sternocleidomastoid muscle (strap muscle between the clavicle and to the bone of the skull behind the ear). In the center of this 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. No strong muscle protects this area.
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