Topic 3 - Medical and physiological safety and well-being - notes

The list of medical or physiological problems which can occur during or as a result of BDSM activities is quite long. This topic isn't intended to cover all types of medical injury or risk which exist in BDSM, but it does attempt to give you an overview of what can and does happen so that you can make efforts to avoid them happening and so that you are prepared for when they do.

Let's start with minor injuries which can occur during a typical scene. Abrasions, skin lacerations, bruising and skin tearing can and often do occur during many forms of impact play, such as spanking, caning, flogging and whipping. Cuts and holes through the skin can occur during knifeplay and piercing. Often these aren't avoidable but can be treated with soapy water, disinfectant and bandages.

Sometimes for serious injuries can occur. Sprains, torn ligaments and even fractured or broken bones can occur when a submissive is thrashing around on or near hard surfaces or when a tied-up submissive struggles too much or uncomfortably against their bonds. This can include concussion if they hit their head against something hard, or if they are accidentally allowed to fall during suspension bondage or while be released from ordinary rope bondage if they're standing up. Rest, cold compresses, bandaging or a visit to the hospital may be appropriate for these.

Bad rope ties or clamps left on too long can restrict blood flow to skin and nerves and cause temporary or permanent nerve damage (i.e., permanent numbness or lack of feeling)

Unsafe play with candles or candle wax, propane torches, branding, dragging rope across the skin carelessly and electroplay on the one piece of skin for too long can all lead to burns, sometimes severe. Treat as for any normal burn. In extreme cases go to a hospital or doctor. Worse however, is poorly executed fireplay, particularly on the upper chest of a submissive which can lead to them breathing in actual flame and damaging their lungs.

Wherever the skin is broken or damaged by cuts or abrasions or anything else there is a two-way risk of infection. The person whose skin has been damaged is at risk from infection getting in. This can be from passing bacteria, unclean toys or equipment or from any diseases their partner is carrying. Worse-case scenario is blood-borne infection such as Hepatitis or HIV.

Just as the person whose skin is cut or damaged is vulnerable to infection, anyone engaging intimately with them is at risk of getting any infections they have which leak out through the damaged skin in blood or blood plasma. Again, Hepatitis and HIV are the big risks.

Antiseptics, disinfectants and prophylactics---such as surgical gloves or condoms---can significantly reduce the risk of infection. In general, slosh disinfectants around liberally, especially on "work areas" such as the back or buttocks during flogging.

Note that antiseptics, disinfectants and prophylactics can introduce their own problems. Some people are allergic enough of latex to go into anaphylactic shock on contact with it, and some people can react equally badly to alcohol-based disinfectants. Non-latex and non-alcohol-based alternatives are available, but talk to your partner before you play in case you need something other than what's in your kit.

Note that some toys can't be adequately disinfected to be safe to reuse on other people. This includes toys and equipment made of natural fibre or natural materials such as leather. Once contaminated by the blood or blood products of someone any such piece of equipment should be kept separate to your other toys and equipment (e.g., in its own special, sealed plastic bag) and only used on that same person in future.

Talking of anaphylactic shock brings me to other reactions which may occur during a BDSM scene. An asthma attack is one of them. People who are susceptible to asthma often carry special inhalers which deliver medication directly to their lungs. If your partner is asthmatic make sure you know where they keep their inhaler.

Other allergic reactions can occur including hives (annoying) and sneezing (pretty bad during breathplay). Nausea leading to vomiting is also pretty bad during breathplay and can easily be caused by overheating if mummification is being performed as well as the breathplay. Never, ever leave anyone alone---not even for a second---during breathplay.

Whenever someone is tied up or chained there's a good chance they can't defend or take care of themselves (which is often the point of bondage). You need to be ready to release them at a moment's notice if they start to experience overheating, problems breathing, nausea, cramping, light-headedness or unconsciousness or anything else. Keep trauma shears (scissors used to emergency medical technicians and doctors to quickly cut through and remove any sort of clothing in an emergency and be prepared to use them. Even if it means destroying your favourite rope, do it. Rope can be replaced.

Keep blankets handy in case your partner gets cold.

Heart attacks are possible but unlikely. More likely is fainting, particularly during some forms of bondage. Diabetics may have problems due to the changed rate of insulin uptake in their body due to the stress or changes in their metabolism caused by the scene. If your partner is a diabetic, learn how they treat it and find out what their symptoms are if they start having problems.

Deep Vein Thrombosis (DVT) is typically a traveller's disease where blood pools in the lower parts of the body during extended stays in the one position---such as while flying in an aircraft. The blood can start to clot and then, when the person starts to move again the blood clots are released and start to do damage around the body (such as in the brain). DVT can also occur during bondage when the one position is held for long periods. The solution is to shift your partner around while they're tied, or to regularly untie them and retie them in a new position (which they'll probably enjoy anyway).

Dehydration can be a problem for someone involved in vigorous activity---such as heavy flogging---or during mummification or, of course, when it's hot and humid. Keep plenty of water around and give it to your partner regularly in sips.

A different form of shock can occur when someone is overwhelmed with pain, feeling or other stimulation. Their mind and body can shut down. They may become cold, dazed or confused. In all cases, if your partner seems to be confused, doesn't understand what's going on, or becomes unresponsive, limp or physically cold, stop what you're doing, and get them somewhere safe, quiet and comfortable.
Last modified: Monday, 10 October 2011, 4:42 PM