Dangerous Dares on Social Media Bring Challenges to the ED

In a session last week on global social media challenges that have spurred countless visits to the emergency department, UPMC St. Margaret Quality Manager Faith Colen encouraged participants to educate themselves about these often-self-imposed dares and the associated traumas that do and will likely continue to ensue.

A continually growing number of social media users, especially adolescents, are recording or otherwise documenting risky, unusual or subjectively funny behavior to try to garner more likes and shares on their various channels. Some individuals have even made sustainable income from their viral videos and become household names on video sharing sites like YouTube and Vine.

One of the most successful social media challenges was the ALS Ice Bucket Challenge in 2014. The challenge, aimed at raising awareness of and donations for Lou Gehrig’s disease, involved the participants pouring a bucket of ice cold water over their heads and posting the video online. The challenge went viral and caught the attention and participation of many celebrities.

But the lure of celebrity and the excitement of worldwide popularity through positive reinforcement on social media have encouraged the escalation of “challenges” to a level of one-upmanship that often becomes unsafe or unhealthy, Colen said Saturday in her session “Social Media Challenges: Child, Adolescent and Adult Trauma Risk.”

She noted two categories of challenges—food and drink and risky behavior—and the potential symptoms patients could present with as a result. She said it was vital emergency nurses be in the know about the trending social media challenges because when it goes awry, patients often disguise the very behavior that landed them in the ED.

“If the patient’s story in the ED doesn’t line up, it could be related to a challenge,” Colen said.

She also recommended nurses participate in community outreach programs at schools to talk students through the risks of social media challenges. Highlighting the life-altering results of some challenges might help them recognize the dangers of trying to be a viral sensation, she remarked.


Trending Social Media Challenges, Potential Risks

There is a seemingly unending list of internet-based challenges being performed worldwide every day. And the challenges continue to grow. Below is a list of just some of the challenges emergency nurses may see the effects of on any given day.

Ghost pepper challenge: Eating a raw ghost pepper, which typically results in heartburn and vomiting.

Sprite and banana challenge: Eating a banana and then chugging a Sprite. It often results in lengthy bouts of projectile vomiting.

Warhead challenge: How many warhead candy pieces can you put in your mouth? It results in a lot of drool and a choking risk. A variation of this challenge is the “chubby bunny” challenge, in which the participant stuffs as many marshmallows in the mouth as possible while still being able to say the phrase for which it’s named.

Gallon of milk challenge: No one can drink a gallon of milk and not end up vomiting.

Cinnamon challenge: Eating a tablespoon of cinnamon results in the inhalation of the spice into the lungs and subsequent aspiration.

Cactus challenge: Eating a cactus means a great risk of airway obstruction and damage to the esophagus.

Eyeballing: Participants pour an ounce or more of vodka into their eyeball. This can cause a number of ophthalmological injuries, including retinal lacerations and even total loss of acuity.

Neknominate: The idea is to chug a pint of whiskey and then do something out of the ordinary. The original challenge has escalated to chugging a fifth of a gallon of whiskey. One victim did so and put himself into the trunk of his car. He didn’t make it out alive.

Butt chugging and vodka tampons: Rumors abound of adolescents funneling alcohol directly into the anus and inserting vodka-soaked tampons. Both acts put participants at an increased risk of alcohol poisoning.

Skittle parties: Teens are mixing loose prescription drugs from their homes into a bowl for parties. This behavior can lead to overdosing and myriad other complications from mixing drugs and alcohol.

Jenkem: This challenge has participants inhaling methane gas to get high. In some instances, the gas is produced from human feces in a covered jar placed in the sun for a time, while in rural areas, some have put traffic cones over cow droppings to produce the same intoxicating gases. Since methane displaces oxygen, it can be an asphyxiant in the right ratios.

Salt and ice challenge: Participants apply salt to skin and add ice, creating a thermal reaction that causes burning. In severe cases, patients have burned through an artery.

Car surfing and ghost riding: Passengers surf moving vehicles. Drivers dance alongside when a particular song plays. The trauma risk is great.