His eyes were bloodshot, his voice was hoarse. He complained of headaches, and he had marks on his neck. But Tami and Trent Burfine didn't solve the mystery of what was happening to their son until it was too late. It was Aug. 25, six days before their son's 12th birthday. He was looking forward to school starting, and hoping his birthday wish for a four-wheeler would be coming true. His father, an officer with the Lufkin Police Department, came home on a break for lunch. Father and son talked about video games. Trent Burfine returned to work, only to race home a short time later when his wife called 911. Their 7-year-old daughter had discovered her brother's body in an upstairs bedroom. His father was the first emergency responder on the scene, administering CPR to his own son in a desperate attempt to save his life, even though he knew it was too late. "He'd been dead about 30 minutes," Burfine said. He found his son sitting on the floor, a computer cable tied loosely around his neck, the other end attached to a doorknob. He had apparently lost consciousness after the ligature cut the flow of oxygen-rich blood to his brain. Emergency room personnel were able to get a heartbeat, and Fletcher survived two days before being declared brain dead. He died in a Shreveport, La., hospital. His parents made the heartbreaking decision to donate his organs. The difficult choices would not stop there. Wally and Louise Burfine, Trent's parents, took on the task of going through their grandson's room, clearing traces of the tragedy and looking for what went wrong. They were puzzled by what they found. Their grandson's long-sleeve shirts and pants had been tied in knots. It was a phone call to a nurse friend in California that clued the family in to what Fletcher had been doing - playing the "choking game." It had become epidemic among children in their state, the nurse told them. What it is The game, in which children use a variety of methods to asphyxiate themselves, is nothing new. For years it has been played in one form or another at slumber parties, in schools and in homes. Across the United States, children around the ages of 10 to 16 are playing, often children who are high academic or athletic achievers experimenting with a thrill or to get a "safe" high, without drugs or alcohol. There have been instances of children as young as 6 or 7, and older teens who have been injured or died, according to www.GASPinfo.com, Web site of the non-profit safety awareness association Games Adolescents Shouldn't Play. It is estimated between 250 and 1,000 children die in the United States each year playing some variant of the game, according to GASP. Numbers are hard to track, as many deaths are mistakenly ruled suicides. Fletcher Burfine's death has been ruled accidental. There was no evidence of suicide, according to Lufkin Police Cpl. Mike Shurley, who investigated the case. The Burfines' son appears to be the first death attributed to the choking game in the Lufkin area, he said. Shurley said it was likely the game was going on among other children in the Lufkin community. "Ninety-nine percent of the time (responders) don't get there until it's too late, and that's the sad thing," he said. The game can be played alone or in pairs or groups. Children use some method of applying pressure to their necks or a friend's neck to temporarily block the flow of blood to the brain. Sometimes children choke each other until the person being choked passes out, using ligatures or squeezing each other around the chest or neck, according to GASP and other expert information. Children feel a "rush" when pressure on the neck is released, giving a state of euphoria as consciousness and blood flow are restored. The game causes permanent and cumulative deaths of large numbers of brain cells and can cause blood pressure fluctuations leading to stroke, seizures and retinal damage, according to GASP. The greatest danger of death comes when children play the game by themselves - such as the case of Fletcher Burfine. It only takes a few pounds of pressure for a few seconds on the neck arteries to cause someone to pass out, according to Lufkin Police Sgt. David Campbell. Children think they are in control, but they lose consciousness and their bodies slump, adding a majority of their weight to the ligature pressure, causing death within minutes. Children who have died playing the game were left alone for as little as 15 minutes before someone found them and it was already too late, according to GASP. Those who survive may be left brain-damaged, and bed or wheelchair bound. GASP has compiled data on the deaths of hundreds of adults and children - including Fletcher Burfine - some as young as 6. Many of the deaths happened in Texas. Awareness and prevention "Parents need to open their eyes and know this is real. It is not an isolated incident," said Charlene Sandel of Huntsville. Sandel's 16-year-old son Blake died March 7 playing the choking game. That day, her two sons made a brief stop at home between an early release from school and a trip to the livestock show in Houston. She estimates Blake had been alone in his bedroom about 30 minutes. "After five minutes it's too late. They're dead," Sandel said. Even in Huntsville, her son's story is not an isolated incident. Sandel's friends, Debra and Kelly Sims, lost their 20-year-old son Micah to the game in 2005. The important thing, Sandel said, is to understand that children trying the game are often good students and star athletes, not troubled children with drug and alcohol problems. Her son was a math honor student who loved calf roping and steer dogging. Both boys' stories will be presented at two seminars, offered through the Blackwood Law Enforcement Management Institute of Texas, on Oct. 23 and 25 at Sam Houston State University in Huntsville. The main speaker is Officer Scott Metheny from Upper Moreland Township, Penn. Metheny has recently appeared on national TV News and talk shows and is on the GASP board of directors. About 65 members representing law enforcement, probation offices and school districts around the state are expected to attend the seminars, including Campbell from the Lufkin Police Department. More seminars may be offered at a later date, an institute spokeswoman said. Information is available at www.lemitonline.org. "The single best weapon about this activity is information. Most children have no clue how dangerous this activity is," the GASP site states. "Most parents have no clue that kids are doing this until someone in their lives dies or is damaged by it." Schools seem oblivious to what is happening, and the only way to stop the deaths is to publicize it, especially in schools, according to GASP. Metheny is scheduled to talk Oct. 22 in Huntsville to a group from the Texas Education Agency Region 6 area, which includes Houston, Trinity and Polk counties. Lufkin ISD and Angelina County are in Region 7. A call to Region 7 for information on whether a representative will be attending was not immediately returned. The Region 6 training is free to Safe and Drug Free School member districts within that region. The session is open to other districts and regions. A $45 fee is required. Call Josie Padilla at (936) 435-8346 for information. Padilla said she's found many in the educational system, administrators, counselors and teachers, have never heard of the choking game. "I attended a counselor suicide prevention workshop recently and even the people there did not know," Padilla said. Lufkin ISD Superintendent Roy Knight had not heard of the choking game but said he would look into it. The district has been focusing on awareness of the "cheese" heroin influx, a cheap and deadly form of the drug that has killed a number of Dallas teenagers. The Coalition, a non-profit agency in Lufkin working to reduce drug abuse, is also beginning to learn more about the choking game. "We're going to research that and try to get some information to counselors in schools," said Executive Director Janet Taylor. They also are talking about doing public service announcements by radio, in addition to other education, Taylor said. Parent warnings Fletcher Burfine was days from beginning his seventh-grade year at Lufkin Middle School when he died. Trent Burfine's eyes, pained as he talks about his son's death, take on a deeper facet of grief as he describes the signs he saw but didn't understand. Burfine noticed his son's bloodshot eyes, which sometimes looked gray when he got up in the mornings. At first, he suspected his son might be using drugs. "The cop in me came out. I questioned him. He said, 'Oh, I've been staying up at night,'" Burfine said. "But that wasn't what was going on." They didn't connect that sign with others Fletcher was showing, persistent headaches, neck marks and raspy breath, to anything dangerous. They never dreamed their little boy was showing classic signs of a child playing the choking game. For Sandel, there were no warning signs her son Blake was playing the game. It may have been his first time, or he may have just started, she said. Fletcher was well-liked, active and intelligent, not a troubled child, his parents say. He was a typically daring, rambunctious boy, but he knew the dangers of drugs and alcohol, they said. What he didn't know was how dangerous his new game was. "Fletcher had no concept of his own mortality. He truly believed nothing could hurt him," his parents said. Since their son's death, the Burfines have talked with his friends, discovering he showed a friend how to play the game. Another friend told them of an even younger child who'd been playing, Trent Burfine said. But while many parents, teachers and police have never heard of the game, the chilling thing for the Burfines was that the children they spoke with did. "They actually corrected us on the right term. 'Oh, it's not the choking game, it's the pass-out game,'" Trent Burfine said. The Burfines recommend that parents look for warning signs, watching their children closely and searching their bedrooms for clues. Children can use anything to tie ligatures to, including headboards and other furniture, door handles and closet rods. Fletcher had been secretly viewing videos online on YouTube, possibly watching clips on the choking game, his father said. Experts advise parents maintain strict Internet monitoring, as graphic information on the game is only a few clicks away. Talking about it Sandel encouraged parents to talk to children about the game and its risks. After the publicity on her son's death, there were many students in the Huntsville area who came forward and talked to school counselors, she said. Many had been playing the game and didn't know the dangers. "This is a killer. This is not a game," she said. The Collier County Sheriff's Office in Florida has produced a brochure on the game. They recommend parents treat discussions with children like those about any other high-risk behavior, like smoking, alcohol and drugs. They recommend saying something like: "Some kids think they can get high without using drugs or alcohol by hyperventilating or putting pressure on their chest or neck. This can be just as dangerous, and some kids have actually died doing it." A parent finding evidence a child is playing the game should immediately discuss the life-threatening dangers and consequences, the brochure advises. Tami Burfine said her wish is for educational material on the pass-out game to be taught in schools through the DARE program, which teaches children about alcohol and drug abuse. The GASP Web site includes a DARE petition form asking for in-school education on the choking game and other asphyxia behaviors. Petition comments by surviving parents, grandparents, friends and family from around the country posted on the GASP site are heartbreaking. "My son lost a friend, age 12, to this three days ago, and I had never even heard of this madness," writes Robin Sisouk. "Let's educate our kids. Unfortunately for our community, it will come just a little too late."