The beautiful memes that we see conjure up all sorts of wonderful images; the power exchanges, the subspace, the control, etc. But that can be dangerously misleading.
Breath play is considered one of the most dangerous forms of edgeplay. An understanding of the risks is a must. And even then, understanding the risks will not completely eliminate them.
Before you even begin to consider breathplay, be aware of some of the extreme risks.
This is a bit of a long read. But considering the risks involved in this type of play, it is a minor amount of time needed to read, and has some valuable info everyone should know.
There are several considerations to have in mind when attempting breath play.
Does the person have normal breathing response?
A person who is calm and rested takes an average of 12-16 breaths per minute.
The need for oxygen to the body increases during periods of stress and emergencies.
If a scene involves moments of fear or nervousness, the need for oxygen and breathing will increase.
An orgasm causes a person to breathe faster, and their need for oxygen must be taken into consideration when performing breath play.
Does the person breathe primarily through the nose or mouth?
Are they prone to nosebleeds?
Pressure you may place on the nose can cause a nosebleed. (Not a good scene.)
Does the bottom/submissive have any medical issues?
Conditions as simple as allergies can seriously affect a person’s oxygen need consumption.
Does the person have bronchitis or obstructive breathing disorders?
Again, it’s important to ask before you attempt breathplay on a new person.
Something as simple as a cold can affect a person’s breathing patterns dramatically.
The structure of the throat is quite delicate, and you should think twice before you play by placing your hand around someone’s throat.
There are several important structures in the throat areas.
Two main jugular veins provide blood, oxygen and nutrients to the brain. If the flow of either jugular veins is impaired for too long, oxygen deprivation can cause the person to lose consciousness, as well as much more serious damage, if pressure is continued.
Delicate cartilage (not bone) protect the windpipe, preventing it from closing so a person can continue to breathe. This cartilage can easily be broken or damaged and cause serious breathing impairment.
If you decide to pursue breathplay, consider several options.
Use the inner part of the palm to press inward, directly beneath the chin. It gives the same effect of constricting breath movement, with less danger of causing damage.
Do not use your finger to squeeze down, because where your fingers land will constrict the jugular veins.
The other method is to use the crook of your arm to restrict breath.
Do not use the broad side of your arm without knowing you are using a bone against throat cartilage where severe damage can more likely occur. With the crook of the arm, there is more control of the sub, and less potential for damage.
Pressure on the Trachea and/or Hanging
This form of play requires a lot of caution.
If you are somehow compressing the trachea, it is important to do so by slowly applying pressure and making sure not to apply pressure to the larynx.
One method is to take a curved finger and place it at the part of the throat where it meets the chin and pushing up and back slowly.
Another method is to apply pressure below the larynx (sometimes with a scarf).
A lot of injuries can occur to the trachea this way if you press too hard. If you are going to use a ligature or noose, it is safer if you use one that doesn’t constrict. If it does, make sure it is wide and padded. If it is too narrow, it will cut or twist the skin, causing bruising and damage to areas such as blood vessels, nerves, cervical spine and windpipe. It may also be a good idea to use a dry lubricant such as baby powder and a soft type of rope or ligature.
If you are hanging someone, it is important to never drop them into place. That could break their spine.
A really nice form of rigging for hanging is when a person is raised into place with their feet still on the ground (often referred to as ‘air walking’).
If you decide to try air walking, there is a significant possibility of damage to the spine.
Compression of the chest
One way this is accomplished is simply having a lover lay on you, making it difficult for you to breathe. Since speech is impaired, I suggest using a double-tap on the arm/shoulder as a safe word.
Another form of chest compression is corseting. I can personally attest to how wonderfully hot it is to barely be able to breath in when wearing one.
If you pursue corseting, you should do some research on this particular topic.
However you compress the chest, you need to go slowly and carefully.
It would be easy to break a person’s ribs. When you ease up on someone after chest compression, you should do it slowly or they may faint.
Pressure on the carotid artery
It takes about 15 seconds of pressure on the carotid arteries to cause unconsciousness.
If you use this method, bear in mind that you are cutting off blood flow from the brain and physically stimulating baroreceptors that will cause the vagus nerve to fire off impulses that could cause cardiac arrest.
Other than that, it is vitally important to avoid pressure to the larynx and damage to the blood vessels.
Do not ever twist the skin or underlying structure of the neck while doing this. It could cause injury to the spine or internal trauma to the neck.
A simple way to accomplish this is to stand behind the bottom and place the bend of your elbow in front of your partner’s throat.
Then slowly bend your arm, applying pressure on the carotid arteries, but not on the front of the throat. Many police officers use this hold, however most classify it as a form of deadly force.
The trachea is commonly known as the windpipe and is essentially a cartilaginous tube.
Some people who practice breath control put pressure on the trachea during play.
There are a few important injuries that can come of that.
The trachea can rupture.
This will cause intense pain, gasping for air, and thick secretions in the throat.
This is a medical emergency and proper medical care must be sought immediately.
Another less immediate condition that can occur is Tracheitis.
It is an inflammation of the trachea.
The signs of tracheitis are thick secretions of the throat, swelling, croupy cough, sore throat and fever.
This may seem minor at first and it may correct itself if the throat is rested and use a humidifier to help with the secretions. This can ultimately turn deadly very quickly.
Usually a hospital will deal with this condition by administering humidified oxygen, suctioning the throat, giving antibiotics, and monitoring a person’s vital signs.
In either of these cases there is always the possibility of an emergency tracheotomy and need for medical attention.
This involves an incision that is made through the skin and muscles into the trachea to get air to the lungs.
If you do a lot of play that involves pressure on the trachea, well…unless you have extensive medical training, I wouldn’t recommend doing it. Tracheal compression can go from pleasurable to dangerous very quickly!
I do not have information on whether repeated attempts of tracheal compression will weaken the trachea, but I would personally recommend that if you are going to play in this way you go about it with a slow and even pressure.
This is not something to do violently as it could easily get rough in the heat of passion.
The larynx is the enlarged upper end of trachea below the root of the tongue.
It is the organ of voice and consists of nine cartilages bound together by elastic membranes and moved by muscles.
It is a very intricate structure and can be easily injured. Pressure to the larynx should always be avoided. Here are a few of the injuries that can occur.
A fracture of the Larynx is an incredibly serious injury that needs immediate medical attention.
Some signs of fracture or compression of larynx are loud breathing, choking and gasping respiration, weak and fast pulse, and blue skin.
If left untreated it will usually lead to death.
It can also seriously affect the voice if a person does manage to survive the injury.
I would say that if you do any type of compression of the neck it is important to do some research into emergency tracheotomy.
If this type of injury occurs it will at least give your partner some chance of survival if the air is completely cut off with this injury.
The best way to avoid this injury is to learn where the larynx is and never do any form of play that places pressure upon it.
If you practice some form of breath control that is going to press on the larynx then at least apply it slowly and carefully and try to pad any apparatus that could be used around the neck.
I really cannot stress enough how dangerous the consequences of this type of compression could be.
Laryngitis is also a complication of any form of compression of the larynx.
It is essentially an inflammation of the larynx.
Some symptoms of laryngitis are loss of voice, hoarseness, pain, and sometimes coughing.
It is usually harmless and doctors recommend that you rest your voice, take cough suppressants, and inhale steam.
I would personally look into seeing a doctor for it just in case there is a slight fracture or other problem present causing the symptoms.
The best way to avoid this injury is to not put pressure on the larynx.
At times play puts stress on the blood vessels of the neck, especially the carotid arteries.
This can cause several problems but I’m going to focus on dissection. There are two types, post-traumatic dissection and spontaneous.
For our purposes I will speak of the post-traumatic type.
Post-traumatic carotid dissection is essentially stretching and small tearing of the artery brought on by trauma such as strangulation.
The symptoms of this tearing are visual loss, weakness, numbness, or speech difficulties.
These events may be transient or permanent.
The only treatment is to get to a doctor and have it evaluated.
They usually test using MRI or angiography.
If they find that you are suffering from it you will probably be given anticoagulation (blood thinners) for approximately 8-12 weeks. They may also do repeated angiography before stopping treatment to ensure that the vessels have healed.
I think I should add some perspective about this injury. It most often occurs by people simply turning their head at the wrong time or by going to a chiropractor.
It is a pretty common injury that doesn’t necessarily need a lot of stress to come about.
The best advice I can offer to avoid this injury is that, if you do hanging, you should pad the noose.
If you have your partner strangle you, they should apply pressure to your neck slowly and never twist the neck.
Also, any bondage around the neck should be wide enough that it doesn’t dig into the flesh easily and twist against the skin. A good rule is to not use anything less than 1/2 inch wide.
If I were going to use a ligature of some sort directly against the skin, it would be soft and lubricated with a dry lubricant such as baby powder. I would be careful not to apply so much dry lubricant that I ended up inhaling it. And do I need to add that you should always, Always, ALWAYS keep some emergency supplies (i.e. scissors and first aid kit) nearby during any scene play?
This could have gone under Blood Vessels but I thought it deserved separate attention.
A stroke is basically a sudden loss of consciousness and paralysis caused by a hemorrhage into the brain, blockage of a blood vessel with a blood clot or foreign object, or a rupture of an artery in the brain.
Sometimes during strangulation play, plaque (a fatty substance in the blood vessels) is dislodged.
If that happens, it can lodge itself in the blood vessel and lead to a stroke.
Strokes are unfortunately very common in this society and a few symptoms of one are loss of consciousness, paralysis, unequal pupils (large one on side of stroke), paralysis usually on one side, sweating, slightly lowered temperature, and speech disturbances.
I would think that a person would be more prone to stroke if they have had one before, they have a history of heart or blood pressure problems, they are overweight, in poor physical condition, or they have a cholesterol problem.
If your partner has a stroke they need immediate medical attention.
While you wait for the ambulance, you can help them in a couple of ways.
Handle them very carefully, especially their paralyzed parts.
Keep them lying on their back, head and shoulders slightly raised.
Turn the person’s face carefully to the side if they are having a hard time breathing.
That will let the secretions drain out. If they have anything in their mouths, remove it.
Keep them warm and quiet but don’t overheat them.
Do not move your partner more than necessary.
Do not use any stimulants or smelling salts. The person may be unconscious, but still able to hear what you say…so don’t say things to panic them. Don’t try to give them anything to drink or eat.
Some things that may help you to avoid this problem are regular aerobic activity and good diet (if you like to bottom to strangulation). It is important that if you bottom to this sort of play you get regular physicals that evaluate your general health.
If you have a risk factor such as high cholesterol, then perhaps avoid strangulation play.
If you do strangulation play, be sure that pressure is applied slowly and that no twisting occurs.
If you lessen the trauma to the vessel, you lessen the risk of dislodging something.
Do whatever you can to avoid trauma to the vessels.
The cervical spine is made up of the first 7 bones of the spinal column. There are several things that can happen to injure this area.
I will cover a couple of them.
A fracture in the Cervical Spine will usually cause pain, possible paralysis, fainting, and suppression of reflexes.
A pinched nerve in the area of the cervical spine will mimic a lot of the symptoms of a fracture and is also very serious.
In the long term, if left untreated, it can cause constant pain and loss of muscle tone.
The most important thing to do in the case of spinal injury is to make sure the person does not move.
Calm them and tell them to lay still while you call for medical assistance.
It is important to reassure them that everything will be well as long as they do not move around.
The treatment of these injuries usually involves putting a person in some form of traction so they will not move while the bone(s) are healing. In the case of a pinched nerve, it is possible that surgery will be needed.
There are several things you can do to avoid this injury.
The first being that if you are involved in hanging with your feet off the floor (or being an “airwalker”) it is important that you do not allow yourself to drop into position.
That can lead to serious spinal injury even if the drop is as little as an inch. Remember, hanging was originally not used to strangle someone but instead used to break their neck.
Any ligature is going to be more likely to cause a spinal injury, especially if it is a thin one.
Another risk is if you apply a police style choke hold when your bottom is struggling or if you twist the neck slightly while applying it.
It is very easy to cause injury that way.
Seizures and Fainting
Seizures and fainting take similar first aid so they will be described together and they fall into three categories.
Grand Mal seizures involve a sudden loss of consciousness followed by board like rigidity that changes to jerking muscle movements that gradually disappear. The victim usually wants to sleep afterwards. When they awake they are usually cranky and have no memory of the seizure. There may be incoherent speech, extreme restlessness, and confusion.
Petit Mal seizures last about five to twenty-five seconds. You will usually notice the person’s skin go a bit pale and also notice them begin stare off into space. The eyes may roll back and the head, eyes and upper extremities may jerk slightly. The victim is usually alert right afterwards and able to function normally.
Psychomotor seizures include automatic stereotyped movements of the body combined with partial amnesia. The victim may become angry and act out or have a temper tantrum after experiencing it.
Whatever seizure a person experiences they may find that they a strange feeling, smell, pain, or visions beforehand that signal the beginning of an attack.
Fainting is a sudden loss of consciousness due to insufficient supply of oxygenated blood to the brain. It is also common to faint out of an emotional response to something unpleasant or scary.
Fainting is more common as you get older.
A few things that you may notice in someone before they faint are weakness, dizziness, paleness, sweating, and cold skin. The victim may notice spots before the eyes, numbness, tingling of extremities, nausea, disturbances of vision, shallow breathing (in our case…sometimes no breathing *wicked grin*), and a feeling of light lightheadedness. The pulse is usually rapid and weak.
Both of these conditions in and of themselves are not considered medical emergencies and both are treated similarly.
If your partner faints or seizes, try to ensure they don’t fall and harm themselves.
There is no way you can stop a seizure.
Do not forcefully restrain your partner and loosen any clothing or restraints that may limit their circulation.
Make sure that they have an open airway. In the case of a seizure you might place a pillow under your partner’s head so they don’t hurt themselves.
In the case of fainting, elevate the legs so that the head is lower than the feet. If you can, you might want to gently turn their head to the side so they don’t choke on saliva or vomit.
Sometimes in the case of a seizure a person will stop breathing. Monitor your partner’s condition carefully and make sure that you follow up with first aid for any secondary situation that might arise.
There is very little we can do to avoid these things and still play like we enjoy.
The important thing is how we handle it after it happens.
You need to restore air as soon as possible when a person faints or seizes and give them proper first aid.
The main cause of death involving breath play is that someone is playing by themselves and faints or seizes while unable to remove the device restricting their air.
Airway Obstruction by the Tongue
A simple thing to overlook is that if your partner passes out their tongue might fall back in their throat and continue to suffocate them.
If your partner passes out you can prevent this problem by tilting your partner’s head, chin pointing up.
Place one hand under the person’s neck and gently lift while pushing with one hand on the victim’s forehead.
This should move the tongue away from the back of the throat and clear the airway.
Aspiration of vomit, mucus, or saliva
Sometimes a person can inhale his or her own vomit, mucus, or saliva. This is very dangerous.
Usually a person will not actually draw the materials completely into the lungs.
The symptoms of aspiration of foreign materials is coughing, unconsciousness, cyanosis, cardiac arrest, and cessation of breathing.
If the person begins to develop a problem, the very first thing to do is to position them so they can vomit and keep an open airway.
Remove all gags or bondage immediately. Sometimes the Heimlich manoeuvre can help to clear their airway if something is lodged within it.
If they are coughing make sure to monitor them while you get emergency medical attention.
I have heard that some people have successfully helped in this situation by plugging the victim’s nose and using their own mouths to suction the airway.
There are some things that will probably lower your risk of having this happen in play.
Do not gag the person you are choking.
If you do gag them have a way to release the gag in a second (literally).
Do not put the bottom into such tight bondage that you couldn’t turn them to the side if they needed to throw up.
Don’t play with someone when they have a head cold.
If you have a partner who gets nauseous during play it may be a good idea to stick to shorter times of asphyxiation.
Have fun but most of all play safe!