What to Do When Someone Passes Out

Summer is heating up, and the sun is back at its job of trying to kill us. You can add “heat stroke” to the list of ways you can black out in BJJ, next to chokes and accidental KOs. In this article, we’re going to talk about the common reasons someone passes out in BJJ and what you should do when it happens.

But first, an important rule: Tell your instructor when you have to leave the mats.

As an adult, you may balk at having to ask anyone for permission to go to the bathroom or step outside to take a phone call. You’re not in grade school and you shouldn’t need a hall pass. But I can assure you, as instructors, we do not keep track of your bathroom habits because we are control freaks -- we just want to make sure our students are safe.

What’s the risk of leaving line of sight of an instructor without telling them? I’ve had students pass out after wandering away, and if I had not had my “spidey sense” tingle to go find them, they could have laid there until someone else happened upon them. Thankfully, in my cases, nothing serious happened and it was just new students who were out of shape and couldn’t handle the warm up. But other instructors have told me about students going into private spaces without telling anyone and having heart attacks or strokes and not being discovered until someone else wandered by.

A responsible instructor won’t mind you saying a quick “Hey, I’ll be back in a minute” so they don’t have to wonder why the head count changed, so please do us that favor.

Heat

To protect against overheating, the main things to do are simply drink plenty of water throughout the day and take more breaks on very hot days if you’re training in a warehouse gym with no air conditioning or if you were exposed to the heat or the sun a lot before training.

You should also make sure you know how to spot and treat heat stroke and heat exhaustion for the safety of yourself and others. Here’s a handy infographic from -- of all places -- the Minnesota Department of Health:

Chokes

We spend so much time trying to choke each other out that we’re bound to succeed eventually. The first time you choke someone out can be scarier for you than it is for the unconscious party. They may snore very loudly or convulse or foam at the mouth and roll their eyes back in their head while you look on in horror thinking you just killed them.

The good news is that as long as the choke is released relatively quickly after the person passes out, they will wake up just fine in about 10-20 seconds the vast majority of the time without any assistance. Their brain will “reboot” and they will come to, often with no idea they were unconscious.

Instead of looming over them and panicking so the first thing they see when they wake up is you freaking out, just remain calm and put them in the recovery position (which we will show further down in this post). If you are stepping in to help, it’s often better to send the other training partner away if they are freaking out.

The person regaining consciousness will usually be confused and unable to understand what is going on for a minute. They may think they are still in the middle of a match and try to keep fighting whoever is closest to them (this is why we see after the bell takedowns on MMA referees by semi-conscious fighters). My advice is to just calmly lead them over to a wall to sit against and act like the round ended or it’s time for a water break. Once they have their wits about them, you can tell them what really happened. (I also like to ask what song they heard when they were in dream land, because almost everyone will tell you they heard one.)

If you are interested in the anatomy of chokes and strangles -- and the semantics of whether to call them a “choke” or a “strangle” -- this reddit/r/bjj post goes into great (probably too much) detail: Chokes vs Strangle and Why We Go to Sleep

Knock Out

While most of us are not training MMA where blunt force trauma to the face is the goal, in regular BJJ we can all catch an accidental knee to the head or headbutt that makes us see stars. Whether or not you get hit so hard you are knocked out, you should be aware of the risks of concussions and how the effects can linger for much longer than a few hours. Read up on post-concussion syndrome and how it can cause mood and memory problems that last for weeks or even months.

The immediate first aid for when someone is knocked out from head trauma is the same as what is covered below with the other more serious medical problems.

Medical Problems

If someone loses consciousness unexpectedly and you are not sure why, it could be a medical problem that needs more first aid than just waiting to see if they wake up or putting an ice pack on their head. Loss of consciousness can be caused by low blood pressure, low blood sugar, diabetes, heart problems, stroke, and other medical conditions. Explaining how to handle medical problems is beyond my expertise, but I recommend this article: First Aid for Unconsciousness

Recovery Position

When someone passes out in BJJ, the “ standard solution” is to grab them by their feet and lift their legs in the air like you’re pumping blood from their lower body back up into their head.



As far as I can tell, this does not help at all, but because people will wake up in a few seconds no matter what you do, the practice persists.

To do what first aid training would actually teach you, the appropriate action to take is rolling the person on to their side in the recovery position, as shown here:

That wraps it up! Summer is heating up and we’re all playing a game where the goal is to choke each other unconscious, so stay safe out there!
Matt Kirtley

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