Breath, incl. Choking, Drowning and Waterboarding

You’re viewing a part of RED, the Risk Evaluation Database. Please visit the main page for more information or to see the complete index.

All the risks below are possibilities of the listed activity. They are listed in no particular order. Please do not consider it to be exhaustive or use it as your sole determining factor when it comes to your safety. Some risk possibilities must nearly always be considered; a few of these can be found in the second tab below. Additionally, please note that the list below does not account for acts of intentional malice or for every complicating medical condition. Possible mitigation strategies or more information sometimes appear under risks when given. These should not be considered solutions that bring a risk to 0%, nor should they be considered the only possible solutions or information. Likewise, lack of a mitigation strategy or research being listed does not mean none exists.

Risks

Bruising/bursting of capillaries in face (petechiae) – likely/common

Possible lack of ability to determine when receiver loses consciousness—not everyone’s eyes close

Headaches

Drowsiness

Shock

“Fluid balance has great influence on your blood volume, i.e. how much space your blood takes up. Dehydration can cause a shortage of blood in the circulatory system and thereby cause increased risk of hypovolemic shock.”

Hypersensitive carotid sinus syndrome

Vomit + breathplay can end in vomit in lungs (aspiration).

Risk increases with drug/alcohol use and fuller stomachs.

Damage to larynx and voice

Seizures

Decreased oxygen levels can cause abnormal heartbeat which in rare cases can lead to cardiac arrest — a particular risk of smothering incl. with plastic bags

Stroke

Systemic organ failure

“The patient presented initially with cerebral irritability and florid, noncardiogenic pulmonary oedema which were followed by a prolonged period of the adult respiratory distress syndrome, severe sepsis and multiple system organ failure, although the patient eventually survived. The pulmonary injury following strangulation is proposed to be a result of the generation of marked subatmospheric pressures within the lungs during vigorous inspiration against an obstructed airway, although the processes involved in the so-called neurogenic pulmonary oedema are difficult to exclude.” — a medical description of one patient’s symptoms after strangulation

Death

Brain damage, including short- or long-term memory loss, challenges working and looking at screens, and loss of motor skills

Further info on neurological impact “In addition to direct hypoxic–ischemic damage from NFS [non-fatal strangulation], mechanical trauma to the cervical blood vessels and the airway can cause delayed neurological sequelae. Arterial dissections may occur, leading to stroke weeks later, making it difficult for the victim and healthcare providers to relate the stroke to the NFS event.”

BJJ practitioners are good experts to consult for more information here.

Choking

Air Choking

All general risks

Crushing of windpipe or other cartilage damage

Cervical artery dissection

Broken hyoid bone leading to loss of swallowing and speaking ability

Blood Choking

All of the above—the carotid is actually very difficult to consistently stop in isolation and most of the time, you’re likely hitting other things too

Muscle spasms (usually harmless)

“With some people, the tongue can slip to the back of the mouth and block the airway, which makes a snoring sound.”

“This can be alleviated by lifting the jaw, but is not necessary for short episodes of fainting under 10 seconds. Here, you are better served spending the waiting time checking for a pulse and clear airways.”

Bulge in blood vessels

“An aortic aneurysm typically ruptures at high blood pressure, and since Blood Choke causes a brief increase in blood pressure, in this respect you could – in fact – consider Blood Chokes dangerous.”

Crushing of arteries

Water-based play

All general risks

Developing a phobia of getting ones face wet (interfering with showering and other face washing, can be severe enough to apply to being rained on).

Bacteria or parasites present in water

Varies by region. Bottled/distilled water can mitigate to some extent.

Vomiting; aspiration leading to pneumonia

any solid food in past ~12 hours that remains in upper gastric tract presents aspiration risk

Pulmonary edema can occur from even a small amount of water in the lungs

Dry drowning

If head is not lower than lungs, even a small amount of water can coat the back of the lungs, disallowing it to oxygenate and rendering reciever hypoxic. The lung will not necessarily induce coughing in this case

Laryngospasm – vocal cords clamping shut and requiring special treatment to be reopened, sometimes including medical paralysis and breathing tubes

Water pressure too high from pouring from too high in waterboarding

Threads from waterboarding face coverings loosening and falling down the throat

Ever-present risks

Risks/possibilities to always consider include (but are not limited to):

Psychological trauma, which can be unexpected and long-lasting

A resulting lack of ability to communicate (incl. safewords)

Pre-existing conditions or triggers not being disclosed, therefore increasing other risks without the other party’s knowledge

Equipment failure and the risks therein, both of structural elements (e.g., furniture, hard points) and toys (i.e., risks resulting from the toy breaking and associated jagged edges, shattered glass, etc)

Medical and legal misadventures

If there’s an emergency, who will get this person to the ER? Do you know their first and last name(/how to get to their ID if not) if they’re unconscious? Does any party want/need a cover story, particularly if the answer to the consent-to-assault question is “no”? Has everyone agreed on one that is as close to the truth as possible (medical professionals need what fully happened)?

Can you consent to assault in your state (assault in this case = near any kind of pain purposefully inflicted on a person)? If not, is the person facilitating the experience prepared to accept consequences if a worst-case scenario happens?

Thoughts and reactions of overhearers/onlookers, both kinky and non

Increased danger that comes from the prevalence of whiteness in Fetlife and popular media kinky pictures, leading warning signs and various medical conditions unnoticed on darker skin

To learn how this might appear, please see Mind the Gap here.

Allergies

Fungal/Staph infections from shared equipment

Shock

Fainting from pain, dehydration, shock, prolonged standing etc. and hitting head/bone/nerve

Panic attacks and related symptoms incl. shaking (dangerous especially with sharps) and inability to communicate

Financial responsibility

There’s a very expensive world of possibilities between “nothing went wrong” and “death”; when folks cannot take time off work, complications from play lead to loss of income for some, and job loss for others (or increase of severity of injury/trauma due to lack of ability to rest)

Changes/decreases to ability to heal even if experienced before due to natural aging and wear on the body

Death

The Fetlife post version of this list is available here.