Doctors Must Be on Lookout for 'Choking Game' Warning Signs

Dec. 14, 2009— -- After finding a picture of her son engaging in a dangerous activity known as "the choking game", Michele Mansfield kept her eyes open for additional warning signs that her son was putting his life at risk.

But ultimately, her diligence could not save her son's life.

"No one ever talked about it," said Mansfield of Phoenix, adding that at the time her son Nick Serna likely engaged in the practice -- from 2004 to 2005 -- there was little information available on the deadly game.

"Sometimes he would be in his room, and he would come out kind of dazed and confused," she said. "I would check his eyes for redness, but I never checked his pupil size. You do not always see redness unless they do it for a long, extended period of time."

On Jan. 29, 2005, Mansfield's suspicions were confirmed.

"We called him for dinner and he didn't come," she recalled. "I had been in the room 15 minutes earlier."

Nick had strangled himself using an ace bandage tied to his bed. Mansfield believes that her son had no intention of killing himself, but that a strip of Velcro had caused the bandage to remain around his neck even after he released it.

"He was blue, and it was awful."

Now, new research suggests that doctors, as well as parents, may be less aware than they should be of the warning signs that a child is engaging in this dangerous practice.

The report, titled "The Choking Game: Physician Perspectives," will be published in the January issue of the journal Pediatrics. It details the results of a survey issued to 163 pediatricians, in which nearly a third of the doctors -- 32 percent -- had never even heard of the choking game. A quarter of those who responded could not identify a single physical warning sign of a child's participation in the game, such as bruising around the neck, headaches and bloodshot eyes.