What’s up, keyboard trolls?! I’ve been getting some pushback from some writers about my recent post on the knocking-someone-unconscious trope, and I wanted to take a second to address it. Mostly I’ve been challenged to provide a better alternative, which is totally reasonable.
So if we can’t knock people out with head injuries, how do we neutralize enemies without killing them, Aunt Scripty?
(First of all, yes, head injuries can knock people out, it’s just that anything that’s hard enough to knock them out is enough to also kill them or cause permanent brain damage.
This is a really good question, and one I’ve thought about quite a bit. There are a couple of options that I can think of, but I want to make one thing absolutely clear:
Your characters have to be morally prepared for the fact that any of these techniques could still be lethal. If they’re going to be “neutralizing” someone, that means that they may be forced to take a life. It’s a not-so-good option, it’s not the desired outcome, but it’s a very real possibility. If they can’t stomach that thought (or you don’t want to deal with the fallout afterwards), they may need to find another way to accomplish what they want.
Option A: “Be quiet and put your hands up or I’ll shoot you in the head.”
Why is that gun chained to the….? Okay, fine. New plan. Shaw?
That’s better. (Side note: do not fuck with Shaw.)
A gun to the head can be very convincing indeed, although your characters have to be ready to pull the trigger if the person offers resistance. A gun should never be drawn if the person drawing it isn’t ready and willing to use it. This should be followed by another character, either the subdued themselves or a second protagonist, duct taping someone’s mouth and binding the hands and feet. (Don’t put anyone on their stomachs and don’t hogtie; these are risky.)
Option B: Ketamine.
You guys, ketamine is my very favorite drug. (By which I mean medication. I have actually never done a drug that was not prescribed to me, and I’m not just saying that in case my bosses find this blog.) [if they found this blog I would be in a world of shit anyway, and i would tell you if i had tried anything interesting, which i have not.]
Of all the sedatives one could theoretically use for a chemical takedown, ketamine would be my choice, primarily for its safety. Benzodiazepines would definitely work, it’s just that one of their major side effects is respiratory depression in high doses. (We routinely use 10mg of midazolam IM at work; I would caution that while this is (usually) (eventually) effective, it takes a few minutes before the struggling winds down, and patients may need airway support if this is done.)
Ketamine, on the other hand, works very well, and patients maintain their own airways pretty well, as well as managing secretions (swallowing). It’s a very popular anesthetic in adult, pediatric, and veterinary medicine (there’s a forthcoming post about sedatives vs analgesics; ketamine actually does both).
The reason I like it for this purpose is multifold. For one, it’s just a neat fucking drug. It doesn’t cause the typical unconsciousness that other anesthetics do; ketamine causes the brain to still be awake, but basically get shut off from the outside world, meaning that the person’s eyes may remain open, and they may have rapid eye movement, but they will not be aware of any outside stimulus. This is really unnerving the first time you see it. Watch this child below:
This kid is fully anesthetized and pain free, even though she looks awake.
It isn’t an instant onset, though, because nothing (except MAYBE propofol) is.
For two, there is basically no upper dose limit on ketamine. Once upon a time a child accidentally got100xthe appropriate dose and was absolutely fine; she was just…. anesthetized for 24 hours. Y’know. Just cuz.
An appropriate dose of ketamine, given in the muscle, is 5 mg/kg; basically, everyone under 220lbs would get 1x 500mg dose (5mL syringe) in the thigh, even though for a smaller person (50kg/110lbs) this is a double-dose. As the mg/kg dose rises, onset quickens; typically it’s about 2 minutes from injection to sedation, but again, quicker in smaller people.
The one thing worth noting here is that actually the max volume any one muscle can really take in is about 5mL, so you may want to have your character duel-wield syringes loaded with ketamine (5ml each) and go for one in each thigh, or double-stab the assmeats, if the person they’re taking down is particularly big.
You could even do a “will one syringe do?” moment, where your characters have to decide whether one syringe will “do the job” or if they need two. The cutoff for a single syringe working is probably around 100kg, or 220 lbs.
One thing here is worth going back to, which is the 2-minute onset. Two minutes is a long time, even if functional resistance is lost sooner. People get angry when you inject them in the butt without their consent. Even if they’re going under sedation, they may struggle and fight and make noise. So your characters need a plan for what to do when the target doesn’t go down immediately.
It’s also worth noting that there can be complications with ketamine. Some people’s larynxes briefly freeze up (laryngospasm), some people get transient apnea, and some people transiently desaturate (blood oxygen % goes down). All of these fall under “probably fine”, but it is worth noting that your characters still may kill someone with ketamine. It’s safer than a head strike or shooting someone, but it’s not 1000% guaranteed to be survivable.
Oh, and a certain number of people, coming up from a ketamine sedation, will have godawful hallucinations, because ketamine is a hallucinogen; this is called an emergence reaction, and may be dramatically useful. Imagine being a bad guy and walking into a room: one of your minions is lying on the floor, eyes open but clearly not awake, and the other is screaming and hallucinating in the corner. Neat.
Option C: The Sleeper Hold / Choke Hold / Kill Someone Hold (NOT SAFE, MINIMALLY EFFECTIVE)
This is a common technique in martial arts. Here we see Hulk Hogan doing this to a reporter (who is a willing participant; we’ll get to why I believe this video in a moment)
Watch how quickly this works: the hold begins with pressure at 0:39, he goes completely limp 7 seconds later (0:46).
Hogan used: Blood Choke! It was very effective!
The downside? The victim wakes up/lifts his head another 11 seconds after that (0:57). In the intervening 11 seconds, Hogan has dropped him on the ground so hard that he hit his head on the hard floor and opened up his scalp. (You can see this at 1:09, when he turns around and the back of his jacket has a good hard smattering of blood on it.)
There are two reasons I believe this video is real: one is the head strike and the blood involved; the other is that he actually sued Hogan for the injury.
There are two kinds of choke holds: blood chokes, which compress the carotid arteries, and air chokes, that compress the trachea and prevent people from breathing. As we can see above, a blood choke is rapidly effective, but also rapid offset. They’re relatively safe in young people, but anyone who may have some plaque building up in the carotid arteries they may have a stroke if the plaque gets broken off from the artery wall.
Air chokes can fracture tracheas and kill people, but they’re probably effective for a little bit longer than above, and are routinely used in martial arts as a “victory hold”, so there’s that.
Option D: A+C or B + C = Effective?
The “ultimate” trope-done-right version of getting a sentry or other bad guy under control may just be a combination: a blood choke for temporary unconsciousness, during which a nice dose of ketamine gets injected in the thigh, or a bad guy willingly takes a sedative rather than get shot in the face.
So that’s it for this post!
I hope you all liked it and found it at least remotely useful. As a personal note, I ask you not to try any of these things in real life, and I also give you my Disclaimer of Infinite Justice. Thanks for reading!
Have you ever wondered how I act after 11 hours of anesthesia? You should head over to my YouTube channel and check out my latest video on my surgery youtube.com/c/twothornedroseofficial
“Breathe deeply, Charlene,” the handsome young surgeon said, smiling down at her.
The first breath of the pungent cyclopropane filled her lungs as she locked eyes with the surgeon…another breath as the anesthetist firmly gripped the mask.
Her vision began to waver, arms and legs heavy as she settled on the potent anesthetic vapor.
Another breath as the young surgeon’s face began to fade, distorting into what she thought was a leering grin.
There was a ringing in her ears and the room was spinning.
“Breathe…” a warbling voice cooed as she closed her eyes, surrendering to the gas.
