There’s a long-lasting myth that tongue swallowing during cardiac arrest can lead to suffocation and that it is the primary concern during such an event. However, this unfortunate misconception is the reason so many athletes in cardiac arrest don’t receive the proper care as soon as possible - chest compressions.
In a study from Tel Aviv University in Israel, scientists look at videos from the past twenty years, all of which depict athletes experiencing sudden circulatory arrest (loss of consciousness), and the results are discouraging.
The AHA’s “Hands-Only CPR Demo Video,” as well as the American Red Cross’s “Learn Hands-Only CPR” have a few hundred thousand views which “shrivel next to the staggering number of views of the videos showing Frank Gathers, who died of cardiac arrest while an entire jam-packed basketball stadium crowd watched in disbelief, without anybody providing any form of appropriate CPR," said lead investigator Dana Viskin, MD.
What’s cardiac arrest?
Cardiac arrest is different than heart attack; A heart attack is a blood flow problem, often occurring when an artery is blocked, but cardiac arrest is an electrical problem that occurs when an irregular heartbeat leads to sudden unconsciousness and death within minutes. Read more.
The American Heart Association (AHA) updated the “ABC” protocol - Airway, Breathing and Chest compressions - to “CAB” - Chest Compressions, Airway, Breathing) for responding to cardiac arrest in 2010. But experts are concerned that people may still be relying on “ABC.”
What went wrong? What goes wrong?
Viskin and the team from Tel Aviv University looked at 29 videos of sudden circulatory arrest between 1990 and 2017. 65 percent included a person attempting to prevent tongue swallowing, either by tilting the head sideways or reaching their fingers into the mouth. In only 38 percent of the videos, the person responds with chest compressions, and a defibrillator is used in only two cases. 36 percent of athletes under cardiac arrest died.
"The cardiac arrest events of athletes caught on video and available on the internet portray a very disturbing picture of fellow teammates responding to cardiac arrest incorrectly,” Viskin summarized. “Prevention and/or 'relief' of tongue swallowing' appears to take priority over chest compression in the majority of video-documented events."
The seconds and minutes after an athlete first experiences cardiac arrest depict if they will live or die.
"It is during this time period when the battle for survival can all too easily be lost, particularly if SCA is mistaken for something less immediately life-threatening, therapies are misdirected, or not given at all,” explained Peter J. Kudenchuk, MD in an accompanying editorial.
“It is interesting since the world seems to be moving forward in regard to technology, medical equipment, and research, but in a field with media exposure to millions of people worldwide, we seem to be over a decade behind,” Viskin said.
The present study was published in the journal Heart Rhythm.