Key points
- A collar should sit loosely enough to slide two fingers underneath
- Never tie or clip a collar to anything fixed
- Any pressure on the front or sides of the neck counts as breath play
- Injuries from neck pressure can show up hours or days later
- Safer alternatives can carry the same feeling of control
In detail
- The front of the neck holds the windpipe; the sides hold the carotid arteries and jugular veins. Pressure on the sides can cause unconsciousness within seconds and slow the heart
- Decorative and symbolic collars are generally low risk when they are loose, smooth on the inside and easy to open
- Posture collars hold the chin up and limit movement. Keep them short and remove them at any dizziness or discomfort
- Attach a leash to a harness rather than a collar, and never pull a collar sharply
- Never sleep in a tight or locked collar, and never attach a collar to a bed, wall or hook, where a fall can turn it into a noose
- For control without the risk, rest a hand on the collarbone or chest without pressing, or hold the person's wrists
- If neck pressure has happened, watch for delayed signs: neck pain, a changed voice, trouble swallowing, tiny red dots in the eyes or face, headache, vision changes, or weakness on one side
Warnings
- Delayed signs after neck pressure need same-day medical care; weakness, confusion or trouble speaking means calling emergency services
- Loss of consciousness is a medical emergency, even if the person wakes up quickly
- Belts, ropes and scarves around the neck can kill
- There is no technique that makes pressure on the neck safe
Resources and next steps
- The guide on breath play risks on this site
- Local emergency services (112 in the EU, 911 in the US)
- A first aid course that includes CPR
- Your doctor or an emergency department if any delayed symptoms appear