Q&A: Asphyxiation

i’m writing a story and in one scene, a character is being suffocated. i don’t really know how to write about it but i want to be realistic! would the body twitch or just go limp? would they go into a coma or die? sorry if this is too weird!!

If we’re skipping straight to asphyxiation, without any obvious cause, you’re looking at hypoxia. The victim may become tired, disoriented, or confused, and then pass out, slip into a coma and die.

However, if there’s a perceptible cause, such as someone strangling them, that’s going to provoke a violent response. With a major caveat, choking someone is not as easy as it looks. The import detail is that there are two kinds of chokes. Both rely on cutting off oxygen to the victim’s brain. You can do that either by preventing respiration, or by directly obstructing the flow of blood to the brain. The latter is far faster and more effective, but it’s not what you’d usually call “asphyxiation.”

Choking someone by preventing respiration it time consuming. We’re talking about having to continue to choke them, uninterrupted, for over a minute, while they fight back, and for several more minutes after they lose consciousness, “to make sure.” They will start to fade, and fighting back will hasten the process some, but in combat terms it’s still a small eternity. Just because they’ve gone limp doesn’t mean they’re going to die. Your body is remarkably skilled at breathing, especially when you don’t think about it, meaning there’s a real risk that they’ll begin breathing again after you stop choking them, conscious or not.

As for your other suggestion, they’re probably not going to be twitching. There’s a lot of things that can cause twitching, including messing with their nervous system directly, but the only thing I can think of associated with choking is in erotic asphyxiation. If that’s your thing, have fun, but I don’t think that’s what you were asking about. That’s also a byproduct, not a symptom. Maybe some kind of nerve agent could produce that result while also killing the victim, but I’m unsure.

Also, I usually reserve this for the tags, but I’ll remind you, I’m not a medical professional. I got my my First Aid and Medicine badges over twenty years ago, so this is outside my area of expertise. With that warning in place: You might also see twitching leading to asphyxia if the victim suffered a stroke or seizure. For example, a muscular spasm could close or collapse the trachea. However in that case, the spasm would be the cause of the asphyxia, not a symptom of it.

If it’s just something obstructing the airway that’s going to provoke the victim’s gag reflex, or get them coughing. This can also occur with some gases that will also interfere with breathing. The victim will respond, trying to clear the airway however they can. How well they can offset panic, and think their way through the situation will determine how well they respond. I’m aware a few anecdotal examples where people performed impromptu Heimlich Maneuvers on themselves using furniture, or other convenient objects.

Speaking from my personal, and somewhat distorted, experiences: Someone going for your throat is fucking scary. I’ve never reacted well to someone going there in a fight. You want to see a human being go into a frenzy? Go for their throat. You’re going to get hurt.

So, some unsorted technical information to work with.

Choking with two hands is, ironically, harder than with a single one. Your hands will get in each other’s way. A single handed choke has the disadvantage of being dependent one point of failure, but it is easier.

People do not react well to strikes that go towards the neck or face, (this is isn’t just me.) Or, perhaps, I should say, “they react too well.” Going for choke at arm’s length will give them a lot of time to respond. You’re getting very close to the center of their vision, so they will have an easier time tracking, and reacting to, this movement.

For someone with training, lifting their opponent off the ground with a single handed Darth Vader style choke is significantly easier than it looks, if their foe is against a wall. Downside is the victim will have all their limbs free. I guess if you’re a Dark Lord of the Sith it doesn’t really matter, but this kind of a move is better suited for theatrics and intimidation, not combat. It looks cool, and I wouldn’t be surprised to learn David Prowse could actually dead lift someone with one hand. Buit, you don’t want to do this.

For those times when you need to fake a death with a willing partner, it’s remarkably easy to “fake” a choke in front of witnesses. Just make sure you’re not actually applying too much pressure, play the role, and make sure no one gets a chance to examine the, “corpse.” The major risk here is if you’re trying to fool someone who knows what to look for.

“Safely” choking someone out usually involves coming from behind and wrapping your arm around their neck. Depending on how you do this it could either be simple asphyxiation or a blood choke. One benefit is that you can do this with something in your main hand. Your off hand can be used to fend off their attempts to retaliate.

Preemptively defending against this is actually really simple: Tilt your head forward until your chin is flush with your chest. Any attempt to choke you from behind will now require getting through your jaw. This will defend against both arm bar, and triangle chokes. It even offers some protection against being garroted, and chokes from the front. The key is, it has to be done before the choke gets under the chin, after that it’s too late.

I hope this helps, and please don’t try any of this stuff at home.


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