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What To Do If Choking Goes Wrong

A person being choked may have a cardiac arrest or become unconscious. This is what you should do.

Strangled woman in red lingerie on a sofa.
Shutterstock photo ID: 2053723241 by Dm_Cherry

I strongly recommend not to practice choking. This article is part of a series intended to show that choking is unsafe, may cause brain damage, and is potentially lethal. The advice I give here is intended to mitigate the damage caused by choking. It does not make choking safe. There are no warrantees that any of this will work.

You may find that a partner that you just choke is unconscious and unresponsive.

Don’t panic.

Never, ever, leave your partner and run away! He or she will probably die, and you will probably end up spending many years in jail.

Is there a cardiac arrest?

Cardiac arrest - when the heart stops beating - is a rare occurrence during breath play, but a definite possibility. It is very hard to predict. Even a healthy person who has been choked many times can go into cardiac arrest.

The first thing you should do is to check for a heartbeat. If there is none, you have a life-threatening problem. As I explained in previous articles in this series, a blood choke can induce cardiac arrest by messing with the sensing of blood pressure in the carotid sinuses. If the heart stops beating, every second counts to save your partner’s life.

If there are people around who can reach you, call out for help. No matter who they are. No matter if you and your partner are naked. You need as many people as you can, so that somebody can make an emergency call, while somebody does cardiopulmonary resuscitation (CPR) and somebody else goes searching for an automated external defibrillator (AED).

If you are alone, call immediately 911 (in the USA) or a similar emergency number in your country. If you put your cell phone in speaker mode, you should be able to make that call while you start CPR.

CPR may bring back a person with cardiac arrest, but chances are that it may not. Regardless, you should continue CPR until a rescue team arrives. CPR can maintain enough blood circulation and oxygenation to keep the brain alive. You can learn CPR online here.

Using an automated external defibrillator (AED)

If you have access to an AED, you should use it. But don’t leave your partner alone to go looking for one. AEDs are those electric pads that we see in the movies being used in hospitals. You place them diagonally across the chest, shout “clear!” and press a button to deliver a shock to the heart to start it beating again.

Most CPR classes will teach you how to use an AED.

These days, many public places like shopping malls, public transportation and movie theaters have AEDs. If you are in a public dungeon of a BDSM club, they will probably have one. The Staying Alive app, by Le Bon Samaritain, can be installed for free on your cell phone and can show you where the nearest AED is located. It also shows you how to use one. You can buy or rent an AED, to have it handy if you practice choking.

Unconsciousness but no cardiac arrest

Much more common than cardiac arrest would be a situation in which the person who has been choked has a pulse but remains unconscious. You should be able to restore consciousness with assisted breathing, either mouth-to-mouth or with chest compressions. While you do that, keep checking the pulse and watch out for vomiting.

A person who needs rescue breathing to regain consciousness should be taken to an emergency room or urgent care facility for examination. This is particularly important if the person experiences problems with balance, vision abnormalities, slurred speech or persistent dizziness. Keep in mind that a person in this condition may not be fully capable of making decisions and may misjudge their state. Even if they don’t seek medical attention right away, they need to be closely watched. Don’t leave them alone.

Ideally, a person who has been unconscious for lack of oxygen for more than a few seconds should be examined by a doctor for signs of brain damage a few days after the incident. Brain imaging and other test can detect if some areas of the brain have been injured. There are medication and treatments to help the brain recover. If a person has been unconscious and has dizzy spells, headaches, nausea, blurred vision or difficulty speaking, they need to see a doctor right away.

Knowing CPR doesn’t make choking safer

What I wrote above is meant to increase the chances of survival in case of an accident during sexual choking. It should not be taken as an endorsement of this practice or as a reassurance that knowing CPR makes choking any less dangerous. In the words of Jay Wiseman, the author of SM 101: A Realistic Introduction:

“It's good for people to learn CPR. […] That said, should breath play result in a cardiac arrest, it cannot be reasonably said that doing CPR is reliably likely to revive the victim. Cardiac arrest is a completely out of control disaster. Resuscitation is certainly not guaranteed even for a very experienced and highly trained medical team with all advanced life support equipment immediately available. An inexperienced and minimally trained civilian, likely working alone, faces a much more uphill battle. In the unlikely event that an automatic external defibrillator (AED) was available it should certainly be used, but the battle nonetheless remains very much an uphill one. While CPR training can reasonably be said to mitigate some of the "lesser" risks of breath play, such as respiratory arrest or airway obstruction by the victim's own tongue, it cannot reasonably be said that CPR training significantly mitigates the "greater" risk of a fatal outcome due to cardiac arrest.” Jay Wiseman's "Closing Argument" On Breath Play.

If don’t want to be in a situation in which you have to fight to bring your partner back to life or, even worse, watch them die, don’t do sexual choking.

Copyright 2023 Hermes Solenzol.

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