Physician Awareness of Warning Signs of the Choking Game

Recognizable Warning SignsAwareness Among Those Aware of Choking Game (N = 111), n (%)
Strange bruising or red marks around neck78 (70.3)
Bloodshot eyes and/or petechiae on face64 (57.7)
Ligatures (bed sheets, belts, tee shirts, ties, or ropes) tied in strange knots and/or found in unusual places46 (41.4)
Internet history of Web sites or chat rooms mentioning asphyxiation or choking game35 (31.5)
Curiosity about asphyxiation (ie, “how's it feel” or “what happens if”)34 (30.6)
Disorientation and/or grogginess after being alone25 (22.5)
Unusual demands for privacy25 (22.5)
Locked or blocked bedroom/bathroom doors25 (22.5)
Frequent, often-severe headaches21 (19.9)
Changes in attitude (overly aggressive)16 (14.4)
Wear marks on furniture (eg, bunk beds or closet rods)16 (14.4)