Tongue swallowing' in cardiac arrest victims not a cause of worry, says study

If someone in cardiac arrest needs cardiopulmonary resuscitation (CPR), don’t waste time trying to move the person’s tongue out of the way, experts say.

Attempts to prevent “tongue swallowing” are a major barrier to successful bystander resuscitation of people with cardiac arrest, they warn.

In many cases of cardiac arrests in athletes in recent years, teammates, coaches and fans have tried to clear the athlete’s throat before starting resuscitation because they mistakenly believed there was a danger of tongue swallowing. This practice “is a real obstacle” to lifesaving CPR, researchers wrote in the journal Heart Rhythm.

“There is a gap between what the medical community knows and practices regarding CPR and what is common in society,” study co-author Dana Viskin of Tel Aviv University in Israel told Reuters Health by email.

A cardiac arrest is not the same as a heart attack. In a heart attack, an artery in the heart becomes blocked, and some of the heart muscle begins to die because it is not getting enough oxygen. In cardiac arrest, the heart can’t pump blood to the brain, lungs and other organs. The person becomes unresponsive and either gasps or doesn’t breathe at all.

Viskin and colleagues searched for videos online that showed cardiac arrests during athletic events, including when the first team member began to help, when medical aid arrived, and when and what type of rescue maneuvers were used.

They found 29 videos from 1990 to 2017 that clearly showed the rescue process. Overall, 15 players survived. The videos often showed teammates attempting to “open the airway” to prevent tongue swallowing or choking, sometimes shoving fingers in the throat or pulling at the tongue vigorously to move it out of the way. The researchers also found that media coverage related to the videos sometimes mistakenly reported the importance of preventing tongue-swallowing in these situations.

Many of the videos posted online had millions of views, which could mean that many viewers are learning incorrect ways to address and administer CPR in these situations, Viskin added.

By contrast, the “hands-only CPR demo video” by the American Heart Association and the “learn hands-only CPR” video from the American Red Cross have far fewer views.

“Athletes are the tip of the iceberg, and what applies to them represents the hundreds of thousands of people who have cardiac arrests,” said Dr. Peter Kudenchuk of the University of Washington School of Medicine in Seattle, Washington.

Kudenchuk, who wrote a commentary published with the study, said, “We pay attention when this strikes athletes because they’re elite, young and healthy members of society. But it occurs once every minute to someone in the US, often with the same scenario seen in these videos of athletes.”

Kudenchuk recommends the “No, No, GO!” technique, which first checks whether the collapsed person is conscious and whether the person is breathing normally. If the answer is “no” to both, then bystanders are advised to immediately “GO!” with chest compressions.

“In our community, the emergency dispatcher sends out an emergency response team but also instructs the person on the phone how to do CPR,” Kudenchuk said. “This is the part where the rubber meets the road to save someone.”

Viskin’s team would like to move forward with educational campaigns through the American Heart Association and Red Cross to train the general public about heart attack and CPR guidelines.

“Anyone anywhere can save somebody’s life,” Kudenchuk said. “Keep your hands with you, and you can save lives.”