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The general clinical sequence of a victim who is being strangled is one of severe pain, followed  by unconsciousness, followed by brain death.  The victim will lose conscious-ness by any one or  all of the following: blocking of the carotid arteries (depriving the brain of oxygen), blocking of  the jugular veins (preventing deoxygenated blood from exiting the brain), and closing off the  airway, causing the victim to be unable to breathe.       Only eleven pounds of pressure placed on both carotid arteries for ten seconds is necessary to  cause unconsciousness.4 How-ever, if pressure is released immediately, consciousness will be  regained within ten seconds.  To completely close off the trachea, three times as much pressure  (33 lbs.) is required.  Brain death will occur in 4 to 5 minutes, if strangulation persists.