This spell extracts the air from the targets's lungs, causing swift suffocation. The targets can attempt to resist this spell's effects with a Fortitude save—if a target succeeds, they are merely staggered for 1 round as they gasp for breath. If a target fails, they immediately begin to suffocate. On the target's next turn, they fall unconscious and are reduced to 0 hit points. One round later, the target drops to –1 hit points and is dying. One round after that, the target dies. Each round, a target can delay that round's effects from occurring by making a successful Fortitude save, but the spell effect continues for 1 round per level, and each time a target fails their Fortitude save, they move one step further along the track to suffocation. This spell only affects living creatures that must breathe.

It is impossible to defeat the effects of this spell by simply holding one's breath—if a victim fails the initial saving throw, the air in their lungs is extracted.