Planking or the "Lying-Down Game:" Two Case Reports.
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.
Preventive Medicine and Risk Assessment, University of Ferrara, Ferrara, Italy.|Department of Urgent and Emergency Care, University of Padova, Padova, Italy.|Forensic Medicine and Toxicology, University of Ferrara, Ferrara, Italy.
Stefania
http://orcid.org/0000-0002-3829-5233
S
Barbieri
Department of Urgent and Emergency Care, University of Padova, Padova, Italy.
Paolo
http://orcid.org/0000-0002-1596-6014
P
Feltracco
Department of Urgent and Emergency Care, University of Padova, Padova, Italy.
Luca
http://orcid.org/0000-0002-4993-6833
L
Omizzolo
Department of Legal Medicine, University of Padova, Padova, Italy.
Rossella
http://orcid.org/0000-0003-4769-9720
R
Snenghi
Department of Legal Medicine, University of Padova, Padova, Italy.
Rafi
http://orcid.org/0000-0001-5591-9186
R
El Mazloum
Department of Urgent and Emergency Care, University of Padova, Padova, Italy.
Gianna
http://orcid.org/0000-0003-2855-0728
G
Vettore
Preventive Medicine and Risk Assessment, University of Ferrara, Ferrara, Italy.
Mauro
http://orcid.org/0000-0002-0931-4810
M
Bergamini
Preventive Medicine and Risk Assessment, University of Ferrara, Ferrara, Italy.
Armando
http://orcid.org/0000-0001-6094-3439
A
Stefanati
Department of Directional Hospital Management Padova, University of Padova, Padova, Italy.
Daniele
http://orcid.org/0000-0001-8370-0712
D
Donato
Preventive Medicine and Risk Assessment, University of Ferrara, Ferrara, Italy.
Cecilia
http://orcid.org/0000-0002-6923-5233
C
Ferronato
Preventive Medicine and Risk Assessment, University of Ferrara, Ferrara, Italy.
Francesco Maria
http://orcid.org/0000-0002-4619-6462
FM
Avato
Department of Urgent and Emergency Care, University of Padova, Padova, Italy.
Alberto
http://orcid.org/0000-0002-9124-745X
A
Tredese
Forensic Medicine and Toxicology, University of Ferrara, Ferrara, Italy.
Rosa Maria
http://orcid.org/0000-0002-1003-4007
RM
Gaudio
blunt trauma; health care costs; multiple trauma; planking; serious games; social networks; the lying down game