Indication: Only for bleeding arising from an artery in the neck. Compression of the carotid artery in the case of bleeding from the face or skull is not effective, because the left and right carotid arteries are connected.
The vertebral arteries, which run through the apertures in the transverse processes of the cervical vertebrae, also supply the head with blood and are connected to the carotid artery. The connections between the carotid arteries and the vertebral arteries form the circle of Willis.
Pressure Point: The carotid artery runs between the sterno-cleidomastoid muscle and the trachea. The transverse processes of the cervical vertebrae act as the solid base.
Due to the arterial vascular communications in the circle of Willis, arterial blood will escape from both the distal and proximal side of the damaged artery. For this reason, pressure should be exerted on the carotid artery both below and above the wound.
Procedure
- Place the thumb on the medial side of the sternocleidomastoid muscle, both proximal and distal to the wound.
- Firmly press the artery at both sites, downwards, against the cervical vertebrae transverse processes.
- Avoid any pressure on the trachea [Figure 12].
- Use your thumb to exert direct pressure inside the wound, if the bleeding cannot be controlled using indirect compression.
Figure 12
Compression of the carotid artery can be associated with two complications.
The vagal nerve, a parasympathetic nerve which regulates the heart rate amongst other things. It lies close to the carotid artery, and can be stimulated by the pressure, causing cardiac arrhythmia.
In addition, arterial congestion can stretch the carotid artery wall to such an extent that the baroreceptors are stimulated, resulting in a marked drop in blood pressure.
These complications are of secondary importance if bleeding from the carotid artery cannot be stopped as the patient will bleed to death.