Choking game

The choking game (also known as the fainting game and a wide variety of slang terms) refers to intentionally cutting off oxygen to the brain with the goal of inducing temporary loss of consciousness and euphoria. The choking game (also known as the fainting game and a wide variety of slang terms) refers to intentionally cutting off oxygen to the brain with the goal of inducing temporary loss of consciousness and euphoria. Limited research has been conducted regarding motivations for practicing the fainting game, although thrill-seeking has been identified as a risk factor, as has the perception that it is a low-risk activity. Anecdotal reasons stated include: Reasons for practice are distinct from erotic asphyxiation. Steve Field, chairman of the Royal College of General Practitioners in London, claims that the fainting game is pursued primarily by children and teens 'to get a high without taking drugs.' Children 'aren't playing this game for sexual gratification.' It is frequently confused with erotic asphyxiation, which is oxygen deprivation for sexual arousal. Unlike erotic asphyxiation, practice of the fainting game appears to be uncommon in adulthood. There are two main mechanisms behind many variations of this practice, both resulting in cerebral hypoxia (oxygen deprivation to the brain). The two mechanisms tend to be confused with each other or treated as one but are quite dissimilar although both have the potential to cause permanent brain damage or death. The two mechanisms are strangulation and self-induced hypocapnia and work as follows: A ligature such as a belt or rope around the neck, or hands or arm pressure on the neck compresses the internal carotid artery. Apart from the direct restriction of blood to the brain there are two other significant responses produced by pressing on the neck: This method is responsible for most, but not all, of the reported fatalities. The method is especially dangerous when practiced alone. Involuntary movements can lead to head trauma and other injuries. If standing, loss of consciousness can result in substantial head trauma through falling. In the event that consciousness is not immediately regained, medical help cannot be sought by a third party, observer, or friend. If the administration of CPR or basic life support is needed due to respiratory or cardiac arrest, help would not be available or quickly summonable when unconscious or not breathing. Also this act could be mistaken for suicide when practiced alone, but accidentally observed by a stranger, to whom the motivation behind the apparent 'strangulation' is not known. The second mechanism requires hyperventilation (forced overbreathing) until symptoms of hypocapnia such as tingling, light-headedness or dizziness are felt, followed by a breath-hold. This alone is enough to cause a blackout, but it is widely believed that the effect is enhanced if lung air pressure is increased by holding the breath 'hard' or 'bearing down' (tightening the diaphragm as in a forced exhalation while allowing no air to escape or having an assistant apply a bear-hug). These latter actions may augment the effects of hypoxia by approximating the Valsalva maneuver, causing vagal stimulation. The hyperventilation leads to an excessive elimination of carbon dioxide (CO2) whereas no significant additional amounts of oxygen can be stocked in the body. As only carbon dioxide is responsible for the breathing stimulus, after hyperventilation, breath can be held longer until cerebral hypoxia occurs. The blood also becomes abnormally alkaline as a result of the excessive elimination of carbon dioxide; this subsequent rise in blood pH is termed alkalosis. Alkalosis interferes with normal oxygen utilization by the brain. The symptoms of alkalosis are neuromuscular irritability, muscular spasms, tingling and numbness of the extremities and around the mouth, and a dizziness, or giddiness, often interpreted as a sense of euphoria.