March 2008 The Choking Game

In the February issue of Morbidity and Mortality Weekly Report, the CDC focused on unintentional strangulation among youths. The “choking game” is defined as self-strangulation or strangulation by another person with the hands or a noose to achieve a brief euphoric state caused by cerebral hypoxia.
Someone can become unconscious in a matter of seconds and death can occur within minutes. The consequences of this game are that children can kill brain cells by depriving their brain of oxygen and in severe cases coma or seizures. Children have been reported to have suffered concussions or break bones (including jaws) from falls associated with the choking game. Another side effect is hemorrhaging of the eyes.
Participants are usually youths, more common in males and serious neurological injury or death can occur if strangulation is prolonged. The age group of individuals involved in this risky behavior and who died were between 11-16 years of age. This activity is not limited to one area of the USA nor is there particular risk factors that predispose an individual to engage in this behavior. Although asphyxial games might have been played by youths for generations, the use of a ligature while playing alone appears to be a new fatal practice.
Currently there are no best strategies to prevent the choking game but there are warning signs that parents, educators, and health care providers need to be aware that the adolescent may be playing the game. Some of the warning signs are as follows:
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, belts tied to bedroom furniture or doorknobs or found knotted on the floor
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 other names used for the choking game are: pass-out game, space monkey, suffocation roulette, scarf game, the American dream, purple hazing, dream game, flat liner, California choke, space cowboy, airplaning, purple dragon and cloud nine.
Currently, there are no best methods of preventing this behavior. The CDC is not recommending that parents discuss this game with their children. The CDC is encouraging parents to be familiar with the game and aliases and some of the warning signs that could occur. If the parent feels their child is involved in this game, they should talk to their child and if need, seek additional help.

Dental Screening with Dr. John Bush is upcoming.

Pre-K required immunizations:

Completed series of 3 Hepatitis B

Varicella vaccine or documentation having chicken pox

4 Diphtheria-Tetanus-Pertussis (DPT/DTaP)

4 Pneumococcal Conjugate

3 Polio

4 Haemophilus Influenzae Type B (HIB)

1 Measles, Mumps, Rubella

Physical Examination if new to Pre-K

K requires the following immunizations and current physical:

Completed series of 3 Hepatitis B

Varicella vaccine or documentation having chicken pox

5 Diphtheria-Tetanus-Pertussis (DTP/DTaP)

4 Polio

4 HIB

2 Measles, Mumps, Rubella

Vision screening

Lead screening

Physical Examination

Students entering grades 1-6: Same requirements for K except lead and vision screening.

Students entering grade 6 and who are interested in playing sports are required to submit a current physical examination.

7 th Grade requires the following:

Completed series of 3 Hepatitis B

Varicella vaccine or documentation having chicken pox

5 DTP/DTaP

4 Polio

2 Measles, Mumps, Rubella

Tetanus or TdaP booster

Scoliosis screening

Physical Examination

8 th grade students who are new to Jamestown School must follow the 7 th grade requirements.

The appropriate form must be mailed to the School Nurse-Teacher before the first day of school.