School district knew of 'passing out' game, family friend says (CHELSEA)
Eton boy's fatal strangling game:
Hyperventilation - A Deadly Game
Asphyxiation is no way to get a thrill, teens are told [http://www.mailtribune.com/archive/2002/february/020102n3.htm
FAINTING GAME GETS GIRL, 13, EXPELLED BUT VICTIM
SAYS SHE WAS RESPONSIBLE, TOO «Read the Full Article, Sign up today» Denver Rocky Mountain News; 5/14/1997; Michael
O'Keeffe; Rocky Mountain News Staff Writer
'Fainting game' warnings follow injuries, deaths [http://www.suntimes.com/output/news/cst-nws-faint05.html
AID=/20041205/NEWS01/412050310/1079/NEWS01 (school on video tape..denials..survived)
Soxtalk.com > School kids told to make passing out
Thursday, December 9, 2004
Toledo Police investigating injury at STC Middle School
Police chief cautions parents
Toledo Police Chief Jeff Harnish is advising parents of school students to be
aware of the “Fainting Game” or “Flat-lining” in which young people apparently are choked until unconscious..
Harnish urged parents to warn their children of the dangers of such activity. Warning signs are unusual marks on the neck
and frequent headaches, police said.
By John Speer
From the Department of Pediatrics, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Affiliated
to Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
Received for publication July 24, 2002.
received August 26, 2002.
“Suffocation roulette”: A case of recurrent syncope in an adolescent boy
We present the case of a 12-year-old boy admitted with a complaint of recurrent syncopal episodes. A careful
history taking revealed the cause of the syncopal episodes to be a dangerous game played by adolescents called “suffocation
roulette.” We believe that recognition of this game as a possible cause of syncopal events, together with prompt educative
intervention, might prevent adolescent morbidity and mortality and also might eliminate the need for unnecessary medical investigations.
[Ann Emerg Med. 2003;41:223–226.]
Accidental death usually results when the safety mechanism designed to alleviate neck compression fails.
We believe that this dangerous game should be brought to the attention of parents,
physicians, educators, and social service personnel. Recognition of this game as a possible cause of syncopal events, together
with prompt educative intervention, might prevent adolescent morbidity and
mortality and might also eliminate the need for unnecessary medical investigations.
Deadly game among children and adolescents
To the Editor:
In the February 2003 issue of Annals, Shlamovitz et al1 (article #49) are to be lauded on their description of
a dangerous game of self-inflicted suffocation among adolescents. A case report on a syncopal event in a teenager revealed
a hazardous game called “suffocation roulette,” a finding that demonstrates the potential gravity of the problem. Still, it should be made clear that such tragic stories are not unheard of in the emergency medicine literature
and are more common than hitherto appreciated. Notably, mortality resulting from the “game” has been reported,
further attesting to the importance for parents and emergency physicians to recognize it.
Awareness of the game of producing a temporary state of asphyxia (for other than erotic purpose)
dates back to the observation of Eskimo children by anthropologists decades ago.2 Clearly, such “games”
are not as innocent as the name might imply. A case of reckless assault had even been filed against a teenager in the
act of playing in a game of “pass out” on a school playground.3 A recent nationwide survey of coroner's reports
identified 4 deaths and 1 near-death resulting from self-strangulation. Two of these cases were attributed to a “choking/blackout
game” being played at school by previously healthy boys.4 It was alleged that the game provided a dizzy sensation (resulting
from the impending loss of consciousness), which was described as “cool.” The pleasure derived from such thrill-seeking
behavior has been putatively linked with an altered consciousness level from constricting cerebral venous and arterial blood
flow, accompanied by elevated carbon dioxide tension.
With the evolving acknowledgment of this potentially fatal game, we must question how many cases of “accidental
or suicidal death” might have been ascribed to the “choking game.” The need for increased awareness is clear.
Physicians, particularly those in emergency departments, should learn more about such apparently “childish” games,
just as they would for other teenager risk behaviors (such as substance abuse).
Kai Ming Chow, MD
of Medicine and Therapeutics
Prince of Wales Hospital
The Chinese University of Hong Kong
Shatin, Hong Kong, SAR,