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The application of pressure to the lateral aspects of the neck, called by law enforcement agencies a “vascular neck restraint”, has been used to incapacitate a suspect and works because the brain is deprived of oxygen for the duration of the “restraint”. The maneuver, using the bicep and forearm to compress the carotid arteries, is no different physiologically from a violent strangulation. Pressure to the lateral neck obstructs blood flow to the brain and is well-known to carry the risk of serious physical injury and death. Serious and life-threatening injuries associated with vascular neck restraints include: carotid and vertebral artery dissections, embolic and thrombotic strokes and anoxic brain damage.
When a patient presents with a history of having been “strangled”, “choked”, placed in a “chokehold” or a “vascular neck restraint” the medical provider must understand the importance of providing an appropriate medical and radiographic evaluation. The provider must also ensure that the patient’s forensic needs, including a detailed history and injury documentation, are addressed. The application of “vascular neck restraints” is considered deadly or lethal force by the majority of major law enforcement agencies in the United States.