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A potentially dangerous game has spread to at least one St. Mary’s public school, according to educators, following reports of students in Charles County sent to the hospital last week after holding their breath until they passed out.

The game is called the knockout or passout challenge. People hyperventilate and then hold their breath until they pass out, according to a letter sent home this week to parents by Superintendent Michael Martirano. It has existed in different forms for decades, and “appears to be resurging due to recent postings on Facebook and YouTube,” he wrote.

On Monday morning several students from Margaret Brent Middle School tried the knockout game and ended up in the nurse’s office, Martirano said.

The challenge, which deprives the brain of oxygen, poses risks, Martirano said. “They could fall and hit their head.”

Four students from Margaret Brent were sent to the nurse’s office by a school administrator Monday morning after allegedly attempting the knockout challenge, said Trish Wince, supervisor of health services for St. Mary’s public schools. Those students were OK, she said.

Wince said she has informed all of the school nurses to keep an eye out for the symptoms associated with the challenge, such as dizziness, and to do comprehensive screenings on children who come to nurses office.

“Anytime you reduce the oxygen to the brain, which is pretty much what’s happening [during the knockout challenge], there’s always possible injury to the brain,” Wince said. The stunt also potentially could impact heart functions as oxygen is depleted throughout the body, she said.

“The potential exists for more serious harm or injury,” she said.

News of Southern Maryland students participating in this behavior surfaced late last week after Charles public schools’ Superintendent James Richmond announced three students from Charles County were taken to the hospital after trying the knockout game and several others were seen by school nurses.

“Students are learning about these challenges through social media sites such as YouTube and Facebook, which are blocked at our schools but easily accessible through smart phones and outside computers,” Richmond said in a statement. “We are reminding parents to monitor the sites their children are viewing in order to help us curb this dangerous behavior.”

Martirano said he first heard of the practice Monday morning and then got the report from Margaret Brent Middle School before issuing the letter advising parents.

“There are not county lines when kids communicate,” he said.

Martirano said he is “asking all parents to have a conversation with their children about this latest teenage trend.” They should inform their children about the dangers of the practice as well as possible consequences at school, including disciplinary action and notifying parents if a student is caught trying to play knockout, he said.

Another type of dare may be making its rounds in schools, Charles County’s superintendent said. The “cinnamon challenge” involves trying to swallow a spoonful of the ground spice without drinking water. The dare has spread as videos surface on social networking websites and usually ends with a person spitting out the powdery substance and coughing, choking or vomiting.

Martirano said he was unaware of incidents of the cinnamon challenge in local schools, but that, too, could cause harm to students.

Wince said that if the cinnamon was inhaled, it could cause breathing problems, especially if a person has asthma or other respiratory problems.