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Planking or the “ Lying-Down Game: ” Two Case Reports

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ABSTRACT

Background: The monitoring and management of risks regarding children and young people admitted to the emergency department as a result of dangerous behaviors distributed via the Internet should be based on clinical reasoning and knowledge about these social media–related phenomena. Here we examine 2 cases of teenagers who reported severe injuries while performing the “planking” craze, a challenge that consists in lying face-down stiffly like a board on any kind of surface.

Objective: Our objective is to examine and describe the Internet craze called planking, also known as the “lying-down game,“ through 2 case reports from our experience, enriching this study with information gained through discussions with secondary school teenagers.

Methods: Details of the 2 case reports were taken from electronic medical records giving information on care support processes, care management, and the costs of traumatic episodes. Demographic data, hemoglobin and serum lactate values, and Injury Severity Scores were evaluated. The study took place in secondary schools of our city from 2013 to 2014 during medical education courses, with the aim of analyzing the influence of social media on teenagers' activities and behaviors.

Results: Both patients suffered multiple trauma injuries and needed high-level health assistance. The first patient underwent a splenectomy and the second one a nephrectomy; both of them required a long hospital stay (14 and 20 days, respectively), and the costs for their management have been estimated at US $27,000 and US $37,000, respectively. Their decision to perform the planking in dangerous locations was due to their ambition to gain peers' acclaim through shared videos and pictures.

Conclusions: Reporting and understanding these cases may potentially help prevent future events occurring in similar circumstances: the scientific community cannot leave this problem unaddressed. There is also a role of education resources for health care professionals; for this, we must identify and follow up strange or misleading information found on websites. A key element of this research study was to report physicians’ misperceptions concerning planking and, with these cases used for teaching purposes, improve knowledge of the clinical and forensic aspects of this emerging problem.

No MeSH data available.


Spleen removed through laparotomy.
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figure4: Spleen removed through laparotomy.

Mentions: An 18-year-old Italian boy was admitted to hospital after an accidental fall from a height of 5 meters. Neurological assessment revealed a Glasgow Coma Scale score of 14/15. On admission, blood pressure was 74/45 mm Hg, pulse 145 beats per minute, respiratory rate 32 breaths per minute, and hemoglobin concentration 8 g/dL. The report refers to an accident in which the boy was planking over a balcony; he suddenly lost his balance and fell from a height of over 5 meters, first onto a canopy, which broke his fall to a certain extent, and then a further 2 meters to the ground. The dynamics were precipitation and the boy’s semilateral or lateral left decubitus position during the impact. According to the splenic injury scoring system of the American Association for the Surgery of Trauma, the patient suffered a type III injury, with a subcapsular hematoma exceeding 50%, intraparenchymal hematoma exceeding 2 cm, and a 3-cm laceration through the splenic parenchyma. Classification of splenic injury was based on the rigorous definition of anatomic disruption [16]. Radiographs from the initial examination, which included chest, pelvis, and lateral and oblique cervical spine, were assessed together with radiographs of the specific sites of injury followed by laparotomy for blunt injuries. Abdominal sonography for trauma was used to investigate the splenic injury in the abdomen due to freed blood, and computed tomography (CT) scans were then taken. One hour later, due to sudden hemodynamic instability, sonography was repeated and found positive for trauma; surgical exploration was then decided upon. The subcapsular hematomas and parenchymal disruption of the spleen (Figure 4) were not discovered by ultrasound and did not result in a significant hemoperitoneum, but the subsequent focused abdominal sonography for trauma (Eco-FAST) scan with intravenous contrast helped diagnosis. Because of ongoing hemodynamic lability, the patient underwent emergency laparotomy. The severity of the case included blood accumulating in Morrison’s pouch and in the pelvis and injury to the pancreas. The length of hospital stay was 14 days. The costs for patient 1, although trauma is generally underreported and depends on its severity, were €25,600 (approximately US $27,380) including laboratory and radiological work, intensive care unit stay, operating theater surgery, dialysis, and total costs of hospitalization.


Planking or the “ Lying-Down Game: ” Two Case Reports
Spleen removed through laparotomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5383804&req=5

figure4: Spleen removed through laparotomy.
Mentions: An 18-year-old Italian boy was admitted to hospital after an accidental fall from a height of 5 meters. Neurological assessment revealed a Glasgow Coma Scale score of 14/15. On admission, blood pressure was 74/45 mm Hg, pulse 145 beats per minute, respiratory rate 32 breaths per minute, and hemoglobin concentration 8 g/dL. The report refers to an accident in which the boy was planking over a balcony; he suddenly lost his balance and fell from a height of over 5 meters, first onto a canopy, which broke his fall to a certain extent, and then a further 2 meters to the ground. The dynamics were precipitation and the boy’s semilateral or lateral left decubitus position during the impact. According to the splenic injury scoring system of the American Association for the Surgery of Trauma, the patient suffered a type III injury, with a subcapsular hematoma exceeding 50%, intraparenchymal hematoma exceeding 2 cm, and a 3-cm laceration through the splenic parenchyma. Classification of splenic injury was based on the rigorous definition of anatomic disruption [16]. Radiographs from the initial examination, which included chest, pelvis, and lateral and oblique cervical spine, were assessed together with radiographs of the specific sites of injury followed by laparotomy for blunt injuries. Abdominal sonography for trauma was used to investigate the splenic injury in the abdomen due to freed blood, and computed tomography (CT) scans were then taken. One hour later, due to sudden hemodynamic instability, sonography was repeated and found positive for trauma; surgical exploration was then decided upon. The subcapsular hematomas and parenchymal disruption of the spleen (Figure 4) were not discovered by ultrasound and did not result in a significant hemoperitoneum, but the subsequent focused abdominal sonography for trauma (Eco-FAST) scan with intravenous contrast helped diagnosis. Because of ongoing hemodynamic lability, the patient underwent emergency laparotomy. The severity of the case included blood accumulating in Morrison’s pouch and in the pelvis and injury to the pancreas. The length of hospital stay was 14 days. The costs for patient 1, although trauma is generally underreported and depends on its severity, were €25,600 (approximately US $27,380) including laboratory and radiological work, intensive care unit stay, operating theater surgery, dialysis, and total costs of hospitalization.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: The monitoring and management of risks regarding children and young people admitted to the emergency department as a result of dangerous behaviors distributed via the Internet should be based on clinical reasoning and knowledge about these social media–related phenomena. Here we examine 2 cases of teenagers who reported severe injuries while performing the “planking” craze, a challenge that consists in lying face-down stiffly like a board on any kind of surface.

Objective: Our objective is to examine and describe the Internet craze called planking, also known as the “lying-down game,“ through 2 case reports from our experience, enriching this study with information gained through discussions with secondary school teenagers.

Methods: Details of the 2 case reports were taken from electronic medical records giving information on care support processes, care management, and the costs of traumatic episodes. Demographic data, hemoglobin and serum lactate values, and Injury Severity Scores were evaluated. The study took place in secondary schools of our city from 2013 to 2014 during medical education courses, with the aim of analyzing the influence of social media on teenagers' activities and behaviors.

Results: Both patients suffered multiple trauma injuries and needed high-level health assistance. The first patient underwent a splenectomy and the second one a nephrectomy; both of them required a long hospital stay (14 and 20 days, respectively), and the costs for their management have been estimated at US $27,000 and US $37,000, respectively. Their decision to perform the planking in dangerous locations was due to their ambition to gain peers' acclaim through shared videos and pictures.

Conclusions: Reporting and understanding these cases may potentially help prevent future events occurring in similar circumstances: the scientific community cannot leave this problem unaddressed. There is also a role of education resources for health care professionals; for this, we must identify and follow up strange or misleading information found on websites. A key element of this research study was to report physicians’ misperceptions concerning planking and, with these cases used for teaching purposes, improve knowledge of the clinical and forensic aspects of this emerging problem.

No MeSH data available.