nurse working with children and adolescents should be cognizant of choking games. risky acts in which pressure is applied to the neck and the airway is obstructed to achieve a high. Evidence supports that many children and adolescents do not undersand the grave consequences of choking games nor do they view participation as dangerous. parents, teachers, pediatricians, nurses, and psychiatric-mental health professionals are not alway aware that children and adolescents are engaging in choking games. the purpose of this article is to describe the sign, changes over the year, consequences, and educational resources available for addressing this behavior in children and adolescents. understanding the nomenclature of choking games, how to assess, and how to intervene when participation in this behavior is suspected are also addressed.