Situations when this may occur:

• Diabetes
• Low blood pressure
• Vagal nerve stimulation
• Narcolepsy
• Various other chronic illnesses

Ways to mitigate:

• Talk about this with them in detail. Determine if loss of consciousness is random or is triggered by specific situations. This helps you assess if you are comfortable in handling that situation should it arise. It also helps you plan ahead to avoid potential triggers during a scene if you choose to tie with them.
• Determine if you are willing and able to tie with them in a way that fits within both of your risk profiles.
• If you do not feel that you have the skill or experience to safely handle the situation, don’t tie with them.
• If you choose this path, make sure to take responsibility for that choice. This is your limitation in skill or experience. This is not their fault, don’t make them feel bad about it.
• If you choose to tie with them, plan ahead to better manage risk:
• If there is something they need to do to avoid the issue, have them do so before the scene. E.g. Confirm they have taken their medication as prescribed that day, eaten something before playing, etc.
• Consider asking for support from another rigger, caregiver, friend, or spotter. Ensure that everyone involved in the scene is present during the negotiation and understands what is expected of them should things go awry.
• Ask the rope bottom what response they need from you if they start to fall unconscious or fully lose consciousness. If they are tied, they cannot act to help themselves as they normally would; therefore, you are responsible for acting and getting them the required care. This is one of the key responsibilities of power exchange.
• For example, if a diabetic starts to go low and feels they may lose consciousness, they need sugar. Have some apple juice, a regular Coke, or glucose tablets within easy reach so you can give them to your partner, if needed. Ensure they are in a physical position where they can drink without choking.
• Have a fully charged phone on your person or within reach. Know the number for emergency services in your area (e.g. 911 in the U.S., but other numbers in other places).
• Tie on a padded or cushioned location.
• Choose ties and positions that are seated, laying down or otherwise supported in such a way that they will not fall or can only slump a few inches if they lose consciousness.
• Tie far enough away from any hard object that they cannot accidentally hit anything if they fall or tip over.
• Choose ties that can be swiftly and easily released. Keep in mind that an unconscious person cannot help you, even by holding their own body weight.
• Double check that you have your emergency rope-cutting tool on your person or within easy reach.