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Carotid compression: Difference between revisions
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}} | }}'''Carotid compression''' involves reducing arterial blood flow to the brain by external compression of one or both of the common carotid arteries to induce sensations of lightheadedness or cause loss of consciousness.<ref name=":0">https://en.wikipedia.org/wiki/Syncope_(medicine)</ref> This can be performed using several specific techniques such as the '''sleeper hold'''. Many of the considerations of carotid compression overlap with [[breath control]], although carotid compression typically does not include restriction of airflow and has several additional unique risks. | ||
'''Carotid compression''' involves reducing arterial blood flow to the brain by external compression of one or both of the common carotid arteries to induce sensations of lightheadedness or cause loss of consciousness.<ref name=":0">https://en.wikipedia.org/wiki/Syncope_(medicine)</ref> This can be performed using several specific techniques such as the '''sleeper hold'''. Many of the considerations of carotid compression overlap with [[breath control]], although carotid compression typically does not include restriction of airflow and has several additional unique risks. | |||
== Background<!-- Provide background information for this kink. --> == | == Background<!-- Provide background information for this kink. --> == | ||
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* Vision changes (loss of color vision, vision going dark or closing in) | * Vision changes (loss of color vision, vision going dark or closing in) | ||
When consciousness is lost, the subject will have no ability to control their body and may exhibit specific involuntary signs, such as: | When syncope occurs (i.e. consciousness is lost), the subject will have no ability to control their body and may exhibit specific involuntary signs, such as: | ||
* Eyes rolling back into the head | * Eyes rolling back into the head | ||
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== Methods<!-- Describe the techniques and approaches for how this kink is typically performed. --> == | == Methods<!-- Describe the techniques and approaches for how this kink is typically performed. --> == | ||
* The "sleeper hold", which uses a triangular | * The "sleeper hold", which uses the arm or leg to in a triangular hold which occludes both carotid arteries from lateral compression. When properly executed, this hold does not apply pressure to the trachea (windpipe) and airflow is not restricted. | ||
* Direct compression using the fingers or hands | * Direct compression using the fingers or hands | ||
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* Cardiac arrest (from the [[wikipedia:Carotid_sinus|carotid sinus reflex]]) | * Cardiac arrest (from the [[wikipedia:Carotid_sinus|carotid sinus reflex]]) | ||
== Risk mitigation <!-- Describe the risk mitigation for this kink. --> == | |||
Even with advanced knowledge and training in specific techniques, carotid compression cannot be made completely safe. In general, techniques for carotid compression aim to apply the minimum pressure required to achieve the desired effect without compressing or stretching nearby airway or other vascular structures. | Even with advanced knowledge and training in specific techniques, carotid compression cannot be made completely safe. In general, techniques for carotid compression aim to apply the minimum pressure required to achieve the desired effect without compressing or stretching nearby airway or other vascular structures. | ||
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Loss of consciousness can occur very rapidly with limited warning. When this occurs, subjects will completely lose control of their bodies and must be prevented from falling. Furthermore, it is important that to carefully position the subject into an appropriate recovery position which does not obstruct the airway and facilitates restoration of blood flow to the brain. The individual should be laid down with their head on the ground. If consciousness does not immediately return, the legs should be elevated to promote additional blood flow to the brain. If the subject remains unconscious, the presence of pulses should be assessed and CPR may be required. | Loss of consciousness can occur very rapidly with limited warning. When this occurs, subjects will completely lose control of their bodies and must be prevented from falling. Furthermore, it is important that to carefully position the subject into an appropriate recovery position which does not obstruct the airway and facilitates restoration of blood flow to the brain. The individual should be laid down with their head on the ground. If consciousness does not immediately return, the legs should be elevated to promote additional blood flow to the brain. If the subject remains unconscious, the presence of pulses should be assessed and CPR may be required. | ||
When consciousness is regained, subjects may be extremely disoriented and should be prevented from accidentally | When consciousness is regained, subjects may have seizure-like involuntary movements and be extremely disoriented and should be prevented from accidentally injuring themselves or others until they have fully recovered. | ||
Carotid compression should '''never''' be practiced when carotid plaques could be present due to the high risk of plaque dislodgement and embolic stroke. More than 50% of older adults (>60 years old) have some degree of carotid plaque formation. Middle-aged adults (40-60 years old) can develop carotid plaques, with higher prevalence among those with risk factors (hypertension, high cholesterol, smoking, diabetes, cardiovascular disease). | Carotid compression should '''never''' be practiced when carotid plaques could be present due to the high risk of plaque dislodgement and embolic stroke. More than 50% of older adults (>60 years old) have some degree of carotid plaque formation. Middle-aged adults (40-60 years old) can develop carotid plaques, with higher prevalence among those with risk factors (hypertension, high cholesterol, smoking, diabetes, cardiovascular disease). Additionally, patients who are predisposed to arrhythmias may be at higher risk of experiencing sudden cardiac arrest from compression of the carotid bodies. | ||
== Known incidents<!-- Provide a list of links to articles describing incidents involving this kink. --> == | == Known incidents<!-- Provide a list of links to articles describing incidents involving this kink. --> == | ||