Instead of showing you cute pictures of me tied up in weird positions and clothes, I thought I should take this opportunity for the first time to do some public education on some of the dangers of BDSM.
I often repeat the fact that BDSM is a potentially lethal activity, but it should be added that so is driving a car. What makes BDSM a bit different is the fact that you don’t need a license to tie someone up, and unfortunately a lot of people are not sober while tying up either. It is for that reason that everyone in the scene is responsible for making sure that our colleagues in BDSM are familiar with the leading causes of death in the scene.
The first two factors cover an absolute majority of all BDSM casualties. The last one is more of a trivia fact, but lethal nonetheless.
Hypoxia
When asked about the dangers of breath control, most people reply with the term asphyxiation. Asphyxiation is however an umbrella term for any problems in breathing, and I would argue that hypoxia is actually, along with the vasovagal response, the leading causes of death in BDSM, and also caused by things that have nothing to do with breath control at all.
Hypoxia means the lack of oxygen in the human body, and what makes it especially dangerous is the fact that humans in general are very poor at noticing it. This is evident in many contexts, such as hypoxia-caused shallow water blackouts that kill swimmers and freedivers. And commercial flights crashing into mountains. What people actually sense when they get “the urge to breathe” is an abnormally high carbon dioxide level. This is easily demonstrated with rebreathing, where a person continuously re-breathes his own air, causing a rise in carbon dioxide and an increasing urge to breathe. This is something that properly uses the body’s own warning mechanisms.
However, if oxygen is simply replaced with something else, such as nitrous oxide, the normal warning mechanisms of the human body do not work, and a sudden loss of consciousness may occur. If unconsciousness results in the victim being unable to get fresh air, death will follow.
How to mitigate the risk: Recognize that hypoxia may cause loss of judgment and unconsciousness without warning. Do not use inhalants alone.
Vagal nerve stimulation
The vasovagal response has a proven history of killing BDSM players. Most people know that activities such as choking or otherwise causing excessive pressure on the neck are dangerous and potentially lethal, but the methods of action are less known.
The vagus nerve is a nerve passing through the side of the neck and one of its responsibilities is downregulating the heart rate of a human being. In normal situations the nerve functions properly, but certain situations, including pain and neck pressure, may fool it to believe that the heart rate should be lowered when in fact it should not. This will usually result in a sudden drop in blood pressure, and is one of the main causes of sudden fainting.
Most cases of the vasovagal response resolve by themselves and the following unconsciousness is brief. However, if the nerve is continuously simulated, for example by a too tight collar or a vac bed, the low blood pressure may lead to a circulatory shock, and eventually death.
How to mitigate the risk:
- Be extremely careful with any collars, hoods, straitjackets and other BDSM gear that may exert pressure on the neck, especially on the side.
- Advise the sub to immediately notify you of any feeling of lightheadedness, tingling in the extremities or visual disturbances.
- Constantly monitor the sub for a sudden loss of consciouness.
Commotio Cordis
Commotio cordis is a sudden disruption in the normal beating of the heart, caused by a strong blow in the area near the heart at the exact right (or wrong) moment of the heart rhythm. It is a relatively rare cause of death, and occurs usually in forms of sport where there is a risk of impact, such as soccer, baseball or ice hockey. However, if it occurs, without immediate help of a defibrillator, death usually occurs.
How to mitigate the risk: In impact play, avoid strong impacts in the heart area.