Sex can be deadly… unless you know the right survival techniques to employ when a tumble turns into a tragedy, according to Spa! (6/27).

Take the case of somebody who starts hyperventilating and continues to struggle for breath even after the deed has been done. Most important, Spa!’s medical experts recommend, is relaxation and breathing in air they’ve already breathed out.

“If somebody takes a quick breath every 2 seconds for a 5-minute period, there’s a chance there may be a shortage of carbon dioxide in the bloodstream and the person will start to hyperventilate. This needn’t be a life-threatening scenario, but it’s typical for panic to occur as the person feels they’re losing oxygen or shaking. It’s important to relax the patient and get them breathing properly,” Dr. Yuji Ikari, a specialist from the Tokai University Hospital who deals in heart attacks, tells Spa! “If they’re breathing really quickly, make them breathe into a paper bag or one of the plastic bags they give out at convenience stores and get them breathing in all the air they’ve exhaled. They may not cooperate, but remember that if it took them five minutes to reach a state of hyperventilation, it’s only natural it will take five minutes of regular breathing to get them back to normal. Five minutes is a long time, so making the person feel relaxed at first is extremely important.”

Then, there’s the case of getting stuck together longer than planned.

“It doesn’t happen much, but there are cases where rescuers are sent out to deal with it,” paramedic Keisuke Watanabe tells Spa!

Watanabe says that when couples can’t break apart and remain enjoined, it’s not simply a matter of waiting for the guy to soften up, so to speak.

“If vaginal spasms cause the entrance to the vagina to tighten up, it prevents blood from flowing back out of the penis and keeps it erect. It’s extremely painful for men,” Watanabe says. “Basically, the only way to deal with it is to inject the woman with a muscle relaxant to end the spasms, so there’s not a great deal the couple can do to help themselves. I suppose the best advice I can give is try as best you can to put some clothes on.”

Also a painful condition is when a man’s erection fails to subside. In fact, this can actually have fatal consequences, as heart attack specialist Ikari explains.

“Blood stops flowing back into the body,” Ikari says. “If you don’t treat the condition, it could lead to necrosis. And in worst-case scenarios, amputation may be the only answer.”

Of course, the most common bedroom fatality is, fukujoshi, or death atop the stomach.

“Don’t forget that blood pressure rises when you’re having sex,” paramedic Watanabe tells Spa! “Preventing (fukujoshi) is best done by keeping a close monitor of your blood pressure.”