Medical Safety

by Chicago BDSM

PHYSICAL ROPE SAFETY

Now this is some common problems (but not all the possible problems) that come along with rope bondage, or bondage in general. I am not a doctor, or health expert, so if you need more insight or info, please consult a health/medical professional.

PHYSIOLOGY CHANGE

It is very common to have someone's body go through changes while in bondage. The mind works differently, thus the body starts working different also. Both the top and bottom have to expect this.

CIRCULATION CUT OFF (Numbness)
The most common problems with rope bondage is blood circulation being cut off. This most likely happens with the wrists, upper arms (you can feel a divot in the muscles on the outer upper arm) and ankles. Rope can easily cut off the blood supply to the limbs, hands and feet by pinching the veins / arteries. At first, this will make the finger or toes start to tingle and feel like tons of little needle pricks. This tells the person that blood is being cut off to the area. If not relieved, the area will go numb. Now damage is not actually being done at this point, it is not am emergency. It will take at least several hours for damage to actually happen even as much as 8 or more, so do not freak out when this happens. As long as a person can move their fingers and toes freely they should be fine.

If there is a circulation problem - just fix what is causing it, rearrange the rope or change the position of the limb. Some rope victims even like having numb limbs while bound so for them it is not a problem at all. Mostly what happens when blood circulation is cut off, is less oxygen is being given to the cells, and less waste (nitrogen) is being removed from the cells. But when circulation is regained, things will turn back to normal shortly. Note:In hospitals, the common practice it to flip patients over every 4 hours, to make sure if they do not have damage numb limbs or get bed sores.

NERVE COMPRESSION (limpness)

Now nerve compression is a lot more serious issue then blood circulation problems. Nerve compression can happen faster than circulation problems, even instantly! It can leave temporary, semi-permanently or even permanent damage! This is caused by the rope crushing the nerves that are between a bone and close to the surface of the skin. This happens most commonly in the upper arms just below the shoulders in the divot, wrists and ankles just like Circulation cut off … but can happen anywhere and is totally different with every individual!

The feeling from nerve compression will vary from it feeling similar to going numb from circulation problems BUT will NOT be able to move their fingers or toes, too a serious drilling pain (and not a good pain)! Your victim will know if they are feeling a nerve crushing pain, but if they are going numb, the best thing to do is make sure they can move the hands and feet on there own frequently. If they can not do that, there is a problem and remove them from the rope immediately!

(STATs: Jay Wiseman says he could find almost no examples of permanent injury resulting from circulation restriction. The rules about testing hands for color or temperature are worthless. He says the only real sign of rope being too tight is pain. You can have numb hands for a long time with no problems resulting. Most people don't like the feeling of numb hands and it can bring a bottom out of headspace. So it's good to be able to spot them. I also find that if the bottom is playing with their fingers, that's typically a signal that they're going numb. There are two ways to get a numb limb: compress a nerve or compress an artery. It appears that cutting off the blood supply to a *nerve* isn't harmful unless it is done repeatedly. A very interesting article I stumbled upon (http://www.madsci.org/posts/archives/dec96/850996021.Ns.r.html) states that about 15 minutes after a nerve is compressed, the skin begins to feel numb. Fifteen minutes later, temporary paralysis can set in which will abate after about a minute once the blood supply is restored to the nerve. It's only 40 minutes or more after the nerve has been compressed (25 minutes or more after the skin feels numb) that recovery time can extend into hours, days, and weeks. These are, apparently, called "Palsies." These, too, recover, but only after extended healing times. I have suffered from "Handlebar Palsy" which occurred after too many hours on a bike (I could no longer do the Vulcan "Live long and prosper" sign) and it took about a week to heal after I stopped riding. So there's PLENTY of time to react to a numb limb if the cause is a compressed nerve. And the consequences of dawdling simply extend the healing time from a few minutes to a number of days (not a good way to keep a sub around, by the way). If the cause is a compressed *artery*, then things get a little more serious if only because it takes more pressure to overcome the 100 mm-Hg (100 Torr or 2 psi) blood pressure than it does to compress the capillaries surrounding a nerve. I don't know what damage ischemia (loss of blood supply) can do to muscles and tissue over the period of 30 minutes, so I'll refrain from commenting further. I am reminded by an MD friend of mine that the damage cannot be TOO great: People have sewn limbs back on and had them work.... I guess the upshot of this long-winded (and very geeky) reply is that most of us do not like numb limbs and they feel bad; but they're not quite as dangerous as they seem. This doesn't obviate the need for a good bondage top to recognize and correct the problem, however. )

Other Instances to look out for while standing in bondage…

Knee locking: Do not let the victim knock their knees. This greatly changes the flow of blood, and blood pressure, and can cause them to pass out!

Pressure on sternum: Watch out for putting excessive pressure on the sternum, this can also make someone pass out

MEDICAL HISTORY and INJURIES:

You want to know about your bottom's medical history and injuries. It is common for people to have injuries, and have medication needs. For example if someone is diabetic, you want to keep their insulin and / or juice around to help control their sugar level. It also common for people to have shoulder and knee injuries, so you have to plan to keep pressure off those joints or any other injuries the bottom may have. Also keep any medicine that may be needed in hand, such as breathalyzers, and medications.

ROPE REMOVAL (End of the scene)

Rope Burn:
When removing rope (and putting on rope), you have to watch out for rope burn. Rope burn is caused by friction of the surface of the rope against the skin. The faster you pull rope, the more chance rope burn will occur. This is not necessarily a bad thing though; some rope victims love rope burn! But if you don't want to cause rope burn, you just have to pull the rope through slower. Also the different rope materials cause rope burn faster than others. Remember taking rope off can be as sensual as putting it on!

Joint Hardening:
If they are in a position for a long period of time, which usually starts after 15 mins, the joints will stiffen. This is because joints are meant to being free and moving, when they don't move they freeze up. You will have to ease them out of the position let them move slowly into a neutral position. If they move the joints too fast, which they will try to do, it will hurt a lot! You will have to help support their legs/arms and then lower them slowly at their pace once they realize what is going on.

Balance:
When taken you victim out of ropes, most likely they will not be able to keep balance, especially if they were in sub space, or exhausted and weak from the bondage.

Rope Marks:
When you remove rope from the skin, you will see rope marks. Personally I consider this one of the more lovely and artistic elements of rope bondage! There are 2 things you can do: Just leave them alone, and let the blood naturally flow back to the surface of the skin, Or you can do a light massage on those areas to get the blood flowing back to the surface and most likely the rope victim will consider it the best massage they ever got! But both are fine, depending on your scene and preference of your play partner.

Temperature,
Your victim will most likely get cold, from coming out of subspace, and crashing from subspace or several other reasons. So keep a blanket around to put on them to warm them up.

Water and food:
People lose a lot of liquids while in bondage, so it good to keep water around for them to drink during and after the scene. They will need it! Most likely your victim will also need sugar or food to replenish their system once out!

Other Aftercare
Depending on your scene and victim, aftercare varies from victim to victim. So communicate with your partners to see what they need. It can be anything from totally leaving them alone, to cuddling.
(see shevah's hand-out)

Emergency Removal:
Remember that rope is cheap, and easily replaceable, a good Victim is not! So if there is a problem, and you don't think you can safely remove the victim in time, DO NOT hesitate to cut the rope off with EMT shears! You have to recycle your victims, so you can use them over, and over and over! ==B)

1. First, you have to keep your cool! A top that loses control and be more deadly then any situation!
2. Secondly, assess the situation. Sometimes cutting a person out right away can put them in more danger then leaving them in and taking them out slowly.
3. If others are going to help you remove, keep control, and tell them what to do! Someone else doesn't know your rope work, and can put your victim in danger by cutting or removing the wrong rope at the wrong time! Having a spotter is a good idea, but either way, keep control of the scene!
4. Do not hesitate to call 9-1-1, its better to be safe then sorry.