The Judo Choke: Resuscitation Techniques (Kappo)

By Neil Ohlenkamp

Editor's Note: This, the second of two articles on The Judo Choke, discusses resuscitation techniques that may be used if a choke has rendered the recipient unconscious. The first article discussed the proper way to execute chokes and avoidance of dangerous methods.

If you have ever been on the end of a good judo choke you will vividly remember the pressure and pain as the opponents arms (or your own uniform) tighten around your neck. If executed properly it is a safe technique although it is also difficult to resist. If you don't give up you can quickly lapse into unconsciousness. So if you are the person who applied the choke know the signs of unconsciousness. Also know what to do to help your opponent if he should lapse into that state.

If the person against whom you applied a choke becomes unconscious immediately release the victim and lay him or her flat so that blood may flow naturally back to the brain. Placing the victim on his or her side, with the head resting on the arm, will prevent vomit aspiration and facilitate breathing if necessary. Monitor the victim closely to make sure the airway is open and the victim is breathing. The opponent will generally regain consciousness spontaneously and be unharmed. If the athlete does not regain consciousness in 20 to 30 seconds and remains unresponsive to your efforts to revive him or her, medical assistance should be sought immediately.

Judo or other martial arts instructors who teach choking techniques should obtain CPR training and certification for use in case of a breathing or other emergency. Even without chokes, Judo and other martial arts are strenuous physical activities that carries some risks for which the instructor should be prepared.

Try to awaken the patient with vocal or physical stimuli such as tapping or shouting. Check for breathing by putting your face close to the patient's mouth and looking at the chest, listening for air exchange, and feeling for a breath. Keep the airway open and initiate rescue breathing if there is no breathing. If a pulse is absent, commence chest compressions.

There are many old methods of traditional resuscitation that can also assist the victim in recovery. If the outcome is less than desirable these interventions may not be defensible in U.S. courts. They have generally been replaced by CPR which is based on more modern medical knowledge. Among sports coaches and medical professionals in the U.S., CPR is commonly recognized as the appropriate response to a medical emergency.

Nevertheless the traditional forms of resuscitation are considered advanced techniques of Judo and instructors may wish to study them to complete their training for historical purposes or for use in special circumstances.

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 assisting the victim in waking up and focussing attention such as slapping the victim, striking the sole of the foot, or yelling.

• 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.

Note that these resesitation methods are used for those who have lost consciousness through a choke and not other reasons. They are not to be used when the person is unconscious due to a trama, throw or fall where a spinal injury is possible or suspected.

As with other martial arts and most aggressive competitive sports, Judo practice includes the risk of serious injury. Of all the types of techniques practiced in Judo however, choking techniques have proven to be among the safest resulting in relatively few injuries.

References

Canon of Judo. Mifune, Kyuzo. Tokyo: Seibundo-Shinkosha Publishing Co., LTD., 1956

Kodokan Judo. Kano, Jigoro. Tokyo: Kodansha International, 1986

Judo in Action. Kudo, Kazuzo. Tokyo: Japan Publications Trading Co., 1967

Judo. Tomiki, Kenji. Tokyo: Japan Travel Bureau, 1956

The Overlook Martial Arts Reader. Nelson, Randy. Woodstock: The Overlook Press, 1989

Emergency Care for Choke Holds. Boulay, John. Ottawa: "Coaching Review"

Deaths Allegedly Caused by the Use of "Choke Holds". Koiwai M.D., E. Karl.

This page is copyright © 1995/96/97/98 by Neil Ohlenkamp, Encino Judo Club, California, USA. This article was originally published in the January 1996 edition of "Judo Trends Magazine."

Neil Ohlenkamp