Pediatrics“Suffocation roulette”: A case of recurrent syncope in an adolescent boy*
Introduction
Adolescents have acute and chronic medical problems, but the main sources of disease, death, and disability in this population result from risky behaviors and risky environments. The leading cause of death for adolescents and young adults (age 10 to 24 years) in both the United States and Canada is unintentional or intentional injury, which includes motor vehicle crashes or other unintentional injuries, homicides, and suicides. Together, these 4 causes account for almost 75% of deaths in this age group and for more than 80% of deaths of those aged 15 to 19 years.1
A variety of biological, psychological, social, and cultural factors contribute to the likelihood of involvement in risky behaviors. Health-risk behaviors and risky environmental factors occur together among adolescents.2 Unintentional injuries, including drowning, fires, and accidental firearms deaths, account for a large number of adolescent deaths.3 Alcohol and drugs are thought to be related to a considerable proportion of these fatalities.4 We would like to add to the list of practices causing unintentional injuries in adolescents a new game that causes repeated syncopal events.
We could not find any previous reports of such injurious games in the medical literature.
Section snippets
Case report
A 12-year-old boy with a medical history of mild asthma was brought to the emergency department by his father because of an episode of unconsciousness that lasted approximately 4 minutes. The patient did not recall any aura before his collapse and did not remember the events preceding his loss of consciousness. According to the history that was provided by his father, the patient collapsed while playing outdoors with his peers, who did not observe any tonic or clonic movements, change of facial
Discussion
In the United States, a teenager attempts suicide every 78 seconds, commits suicide every 90 minutes, dies in an accident every 20 minutes, and is murdered every 90 minutes.5 Mortality statistics represent only one aspect of adolescent health status. For every fatal injury, approximately 41 injuries require hospitalization, and at least 1,100 injuries are evaluated in an ED. For every fatality from a motor vehicle crash, there are more than 100 injuries. For every gun-related death, there are 5
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(1991)Risks, resilience, prevention: The epidemiology of adolescent health
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Injuries and violence: Risk factors and opportunities for prevention during adolescence
Adolesc Med
(1999)
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Temperament and character profiles of adolescent participants in the choking game
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2016, KontaktCitation Excerpt :In the cross-sectional studies included in the review, the median lifetime prevalence rate of ever having been engaged in in the CG was 7.4% [6]. Cases have been described mainly in the United States [1,9], Canada [10] and France [8,11] as well as in Spain [12], Saudi Arabia [5], Israel [13] and several other countries. These reports are relatively recent; however, according to some sources, the CG has been observed among Eskimo children since long ago [5,14].
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2016, Archives de PediatrieNon-suicidal self-strangulation among adolescents in Saudi Arabia: Case series of the choking game
2015, Journal of Forensic and Legal MedicineCitation Excerpt :Time and again, adolescents' exploratory nature leads them to discover new risky behaviors. In the past decade, there has been increasing reports of an emergent “game” adolescents play referred to as the Choking Game, Pass-out Game, or Suffocation Roulette, amongst others.4–9 This game involves a non-suicidal, temporary self-asphyxiation in an effort to get a “high” or state of euphoria without the risks associated with substance use.4
The choking game: A deadly game. Analysis of two cases of "self-strangulation" in young boys and review of the literature
2015, Journal of Forensic and Legal MedicineFrom risk-taking to behavioural dependency: Addictive disorder to danger
2010, Psychologie Francaise
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Address for reprints: Gil Z. Shlamovitz, MD, Department of Pediatrics, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 64239, Israel; E-mail [email protected].