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"The Choking Game"

The choking game is a dangerous activity that older children and early adolescents sometimes play to get a brief high. They either choke each other or use a noose to choke themselves. After just a short time children can pass out, which may lead to serious injury or even death from hanging or strangulation.

Eighty-seven percent of recent deaths were among males, and most fatalities occurred among those 11 to 16 years old. The deaths occured in youth age 6 to 19 years old; the average age was 13.

According to a 2009 report released by the Centers for Disease Control and Prevention (CDC), choking game deaths were identified in 31 states. CDC found that most of the deaths occurred when a child engaged in the behavior alone, and that most parents were unaware of the choking game prior to their child's death.

Someone can become unconscious in a matter of seconds playing the choking game. Within three minutes of continued strangulation (i.e., hanging), basic functions such as memory, balance and the central nervous system start to fail. Death occurs shortly after. Some non-fatal long term consequences of the choking game can be loss of consciousness and death of brain cells due to oxygen deprivation in the brain (coma and seizures may occur in severe cases), concussions or broken bones from falls, and hemorrhages of the eye.

Parents, educators, healthcare providers or peers may observe any of the following signs that can indicate a child has been involved in the choking game: 

  • Discussion of the game or its aliases
  • Bloodshot eyes
  • Marks on the neck
  • Wearing high-necked shirts, even in warm weather
  • Frequent, severe headaches
  • Disorientation after spending time alone
  • Increased and uncharacteristic irritability or hostility
  • Ropes, scarves, and belts tied to bedroom furniture or doorknobs or found knotted on the floor
  • The unexplained presence of dog leashes, choke collars, bungee cords, etc.
  • Petechiae (pinpoint bleeding spots) under the skin of the face, especially the eyelids, or the conjunctiva (the lining of the eyelids and eyes)

Some of the names used for the choking game are pass-out game, space monkey, scarf game, fainting game, blacking out/blackout, flat liner, space cowboy, and others.

Research is not available on the best strategies to prevent the choking game. However, parents, educators and healthcare providers should be made aware of this public health threat and the warning signs that adolescents may be playing the game.

To learn more, go to Unintentional Strangulation Deaths from "The Choking Game" Among Youths Aged 6 - 19 Years – United States, 1995-2007.

Written by: Lisa Callaham
Posted: Dec 12, 2011 by Lisa Callaham

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