Have you heard of the choking game?

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It goes by many names: ‘black out,’ ‘space monkey,’ ‘fainting game.’ Participants – teenagers, mostly, it seems – play it by cutting off oxygen to the brain. They use belts, neckties, other types of binding – or a friend’s helping hands – to induce a ‘natural high.’

Yet, say authors of a paper published in the January issue of Pediatrics, of the 163 Ohio physicians who responded to a survey, only 111 (68.1%) said they had heard of the game – mostly through popular media sources. Of those who knew about it, only 7.6% reported having a patient who they suspected was
playing the choking game.

That’s a seriously low level of awareness, says Nancy E. Bass, one of the authors of the paper. ‘The choking game may not be as prevalent as other [risky behaviors] like drugs, but the issue is it can result in death,’ Bass said, adding, ‘It’s becoming more prevalent ... if you have an asphyxia related death, it’s difficult to know whether it’s unintentional.’

The Centers for Disease Control and Prevention surveyed media reports and counted 82 deaths between 1995 and 2007 that were likely the result of the choking game. It’s an indication that physicians simply may not be trained to recognize the warning signs, from strange bruises to bloodshot eyes.

Bass said she hopes the paper will encourage physicians – particularly those in pediatric practice and emergency room training – to include the choking game in their general-advice discussions with teenagers, which includes such topics as smoking, balanced diets, school performance and alcohol use.
For a personal account, here’s Sandy Banks’ 2005 story of a family dealing with the aftermath of a likely choking game-related death. Here’s a CDC fact sheet on the choking game and its warning signs.

-- Amina Khan