In the final hours of his life, Tim Piazza lay on a couch in a Penn State frat house barely conscious and occasionally vomiting from alcohol poisoning and serious internal injuries.
Twice on a night of heavy drinking in early February, frat brothers, apparently oblivious to his injuries, strapped a backpack on the very ill young man. Piazza died a day later, February 4, at Hershey Medical Center.
In another, more recent death on a Pennsylvania college campus, dorm mates of Lafayette College freshman McCrae Williams put a backpack on the young lacrosse player as he lay in his bed this September. He had thrown up and fallen to the floor in his room after what has been described as a "day drink" party and possibly another party the night before.
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The college kids in both instances put backpacks on their dying friends in the hope of preventing the young men from turning unconsciously onto their backs and asphyxiating on their vomit, according to authorities.
There is even a term for it now in college circles: "JanSporting," named after the popular brand of backpack used by high school and college students. Another term for it is "the drunk pack." Pillows often are placed in the backpack to prevent a person from turning from his or her side.
One article on the lifestyle website Total Frat Move claims "JanSporting" "just might save" a drunken friend's life, though it also emphasizes that overly intoxicated people shouldn't be left alone, regardless of what position they are put in.
"JanSporting" may be popular on campus, but it is not a prescription likely to gain support in the medical community anytime soon.
"Sadly, 'JanSporting' is another one of those internet-fueled misconceptions that people, especially college students, use to prevent bad outcomes from excessive alcohol consumption," said Dr. Ralph Riviello, vice chair of clinical operations at Drexel University's Department of Emergency Medicine. While "the backpack theoretically can prevent someone from rolling onto their back, aspiration can occur in other positions, and the degree of intoxication and responsiveness are the biggest determinants of aspiration."
He said if a friend is so drunk that unconscious vomiting is a concern, calling 911 is the right and immediate thing to do.
"If someone is that drunk that you are considering putting a backpack on them, you need to call 911. They need to be transported to ED for evaluation," Riviello said.
He said a common misconception among young people, particularly underage college students, is that going to an emergency room for intoxication will lead to ramifications with their college administrators.
But details of their hospital trip are protected by privacy rights and the Health Insurance Portability and Accountability Act known as HIPAA.
"We see a lot of college kids on Friday or Saturday. We never would report them to the Dean’s office or campus officials," Riviello said. "We would encourage kids to seek help or visit their student health center and that sort of thing, but we don’t call the school."
The one call doctors and nurses might make? "We may call your parents if you’re underage and they are close enough to pick you up," he said.
Still, as recent college tragedies should teach other young people, Riviello said it’s better to get to a doctor quickly and live than worry about the embarrassment and fallout from being dangerously intoxicated.
"If you're that sick or you're that out of it, you need medical attention," Riviello said. "Your drunk friends aren’t going to provide the amount of attention that you need."