Carotid sinus reflex
Definition
The carotid sinus reflex (abbreviated to CSR) is a physical reaction that occurs when pressure is applied to the carotid artery. This can lead to a sudden slowing of the heart rate and a drop in blood pressure, resulting in unconsciousness or even cardiac arrest.
Explanation of the carotid sinus reflex
The carotid arteries run on either side of the neck and carry blood to the brain. At the bifurcation of the carotid artery is the carotid sinus, an area with highly sensitive nerve endings that regulate blood pressure. When pressure is applied here, for example by an arm clamp, rope, or hand, the body responds with the carotid sinus reflex: the heart beats more slowly and blood pressure drops suddenly.
In a medical setting, this reflex is sometimes deliberately induced by doctors, for example in certain heart rhythm disorders. In a BDSM context (such as breath play or choking), however, this can happen (un)consciously and is extremely dangerous. The body can lose consciousness within seconds and without rapid assistance, permanent brain damage or death can follow.
Highly risky
Many people think that “light pressure” on the throat or neck is safe, but the problem is not just oxygen deprivation: even a brief touch in the right (or wrong) place can trigger the reflex. This makes it one of the most risky forms of BDSM play.
Safety & points of attention
Triggering the carotid sinus reflex is life-threatening and can lead to cardiac arrest or stroke.
Neck and throat play involving pressure on the carotid artery is considered irresponsible by medical experts.
There is no safe margin; the reaction varies from person to person and can occur even with slight pressure.
If you still want to play with the feeling of powerlessness and breathlessness, use safer alternatives such as gas mask play without closure, controlled positions, or psychological techniques.
If someone loses consciousness, seek medical help immediately and start CPR if necessary.
Many BDSM organizations and safety manuals advise against neck pressure or choking due to the high risks involved.
Related terms Carotid sinus reflex
Breath control
Choking
CSR
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