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During breath play, unless oxygen supplementation and/or a [[wikipedia:Carbon_dioxide_scrubber|carbon dioxide scrubber]] are used, hypoxia will generally present a life-threatening problem before hypercarbia becomes dangerous. | During breath play, unless oxygen supplementation and/or a [[wikipedia:Carbon_dioxide_scrubber|carbon dioxide scrubber]] are used, hypoxia will generally present a life-threatening problem before hypercarbia becomes dangerous. | ||
== | === Negative pressure pulmonary edema === | ||
If breath control is performed by occluding the mouth or nose directly, significant negative airway pressure can be generated as the person struggles to draw air into their lungs. If enough inspiratory force is applied for enough time, the negative intrathoracic pressure can cause alveolar capillaries to rupture. This can cause pulmonary edema, where the lungs rapidly fill with fluid, and is life-threatening, requiring immediate medical attention. If this happens, pink frothy fluid can be seen coming from the mouth. | |||
== Appeal<!-- Describe the reasons why people participate in this kink. --> == | == Appeal<!-- Describe the reasons why people participate in this kink. --> == | ||
== Risks and risk mitigation<!-- Describe the risks of this kink. -->== | |||
Breath control is an extremely high-risk form of play. The specific risks depend on the details of the scene, but can include: | |||
* Death | |||
* Permanent neurologic injury | |||
* Injury to upper airway or blood vessels in the neck | |||
* Vomiting and aspiration | |||
* Lung injury | |||
Many forms of breath play cannot be made completely risk-free, so full consent is complete without an understanding and acceptance of risk. Risk mitigation involves careful planning of a scene to ensure any method to restrict airflow or blood flow is [[fail-safe]]. | |||
Some important specifics to consider include: | |||
* What must occur in order for normal airflow and/or blood flow to be restored? | |||
** Ensure nothing is attached to the mouth or nose unless someone else is able to immediately remove it if necessary | |||
** Due to posturing, someone who has lost consciousness due to hypoxia may not release their grip on an object or move their arm away from their face, so don't rely on a released grip to restore normal flow. | |||
* If consciousness were lost, what position(s) could the body assume? | |||
** Is injury from falling possible? | |||
** Could the body or head fall into a position that would worsen the source of airflow or blood flow restriction? | |||
** Could the mouth or nose become blocked? | |||
* What is the risk that vomiting or aspiration (inhaling of vomit or saliva) could occur? | |||
** Concurrent [[intoxication]] '''tremendously''' increases the risk of vomiting and aspiration | |||
** Is the mouth covered or the head positioned in such a way that fluid in the mouth would be inhaled rather than fall away from the body? | |||
** In scenes with heavy bondage or sensory deprivation | |||
*** Would an episode of vomiting be noticed by others? | |||
*** Could the head be quickly released, turned to the side, and any obstruction in front of the mouth immediately removed? | |||
Breath control is risky for anyone to practice. In healthy people with proper safety practices, some sources of risk can be diminished. <u>'''However, for people with certain health conditions, the risks of breath control cannot be meaningfully mitigated and should be avoided entirely.'''</u> | |||
Many types of heart or lung disease can make any form of breath control dangerous (especially if severe). If airflow or blood flow is restricted in these individuals, a cascade of life-threatening physiologic derangements can be initiated that cannot be easily reversed, even after restoring normal flow. Additionally, neurovascular conditions such as carotid stenosis, Moyamoya disease, cerebral aneurysms or vascular malformations present significantly increased risk of stroke. | |||
Carotid compression should '''never''' be practiced when carotid plaques could be present due to the high risk of plaque dislodgement and embolic stroke. More than 50% of older adults (>60 years old) have some degree of carotid plaque formation. Middle-aged adults (40-60 years old) can develop carotid plaques, with higher prevalence among those with risk factors (hypertension, high cholesterol, smoking, diabetes, cardiovascular disease). | |||
== Methods<!-- Describe the techniques and approaches for how this kink is typically performed. --> == | == Methods<!-- Describe the techniques and approaches for how this kink is typically performed. --> == | ||
* Mouth and/or nose occlusion | |||
* Choking | |||
** Carotid compression | |||
* Gas displacement | |||
** Nitrous oxide | |||
* Rebreathing | |||
== Known incidents<!-- Provide a list of links to articles describing incidents involving this kink. --> == | == Known incidents<!-- Provide a list of links to articles describing incidents involving this kink. --> == |