It was in a Sevilla-Getafe match, in August 2007. He was around the 30th minute when the 22-year-old footballer collapsed in the field, a few meters from the goal. Millions of spectators witnessed the live scene, from the OA stadium through their televisions. Those eternal seconds, the confusion and immediate response of their companions, who threw themselves to help him by opening his mouth and putting his fingers with the intention, that “the tongue did not swallow.” Puerta regained consciousness within a few seconds and left the field by its own foot, but suffered a cardiorespiratory arrest in the costumes and three days later as a result of the sequelae of the heart failure.
His case shocked the world of football and thickened that macabre list of athletes who vain suddenly, in the middle of a tournament, before the stunned look of the world. As the recent episode of the Danish player, who lost knowledge during a match against Finland in the Eurocup of 2021. His teammates also acted “to avoid swallowing the tongue,” the media reported later, although he later also received cardiopulmonary resuscitation and defibrillation, and ended up recovering.
His case, such as Puerta, have now used to make a scientific reflection on cardiac arrest, the wrong concepts of resuscitation and its impact on public opinion: which analyzes about half a hundred televised fades of athletes reveals on Wednesday that there are wrong ideas, such as the fear that the affected person swallowed the tongue, which can hinder an adequate cardiopulmonary resuscitation.
“The myth of swallowing the tongue and its perception as a cause of cardiac arrest is widespread and often delays the beginning of an effective cardiopulmonary resuscitation [empezar con las compresiones torácicas inmediatamente]“, The researchers conclude., Published in the scientific journal Canadian Journal of Cardiologyanalyzed the interventions in 45 cases of athletes who suffered collapses in sporting events and were registered by the cameras: in 38 fades the first action of reanimation attempt is seen and in 84% of these cases it was the forced opening of the mouth to avoid that idea of lingual swallowing; Only six people received adequate resuscitation with thoracic compressions such as initial resuscitation maneuvers.
The authors cite the case of Puerta and Eriksen because, although the vital result was different, the first performance was similar. They do not come to speculate what would have happened in these specific cases if both players had received the most appropriate cardiopulmonary resuscitation, with cardiac massage from the first moment, but they do notice a clear association in all the cases studied: “Almost 70% of the athletes who received attempts to prevention of lingual swallowing died or remained in a vegetative state who received thoracic compressions as the first resuscitation maneuver survived without anxic brain damage [por falta de oxígeno] significant”.
The research also highlights the role of the media in the spread of myths, such as swallowing the tongue. They even document how the press usually praises that incorrect answer. It also passed after the collapses that suffered door and Eriksen. On the latter, there was some means that described the attempts of his classmates to prevent the tongue from swallowing as a “potentially vital action in the response”, the researchers say.
Do you really swallow your tongue?
But what is true in that myth of the danger of swallowing your tongue? Ignacio Fernández Lozano, elected president of the Spanish Society of Cardiology, clarifies concepts: “Language is a very large muscle, which is anchored to the jaw. When one loses consciousness, the tongue is handled badly, it falls by its own weight and can obstruct the airway, but it does not swallow.” Now, it is not necessary to open your mouth, put your fingers, get your tongue … just do “the”. That is, with the victim lying on my back, while with one hand he holds his forehead and the other is placed on his chin, his head is back and moves his jaw up to open the passage of the air. “This maneuver lasts a second,” says Fernández Lozano, so you can start the effective resuscitation actions immediately.
Do not waste time trying to get your tongue, insists the cardiologist. It can even become “a counterproductive maneuver”, because while that is done, not only thoracic compressions are delayed, but the victim can be damaged. Gemma Cuadras, assistance nurse of the Medical Emergency System of Catalonia (SEM) and a life support instructor, coincides: “It is not indicated to remove her tongue or put anything in her mouth. You can harm her, cause him a wound, than blood, and obstruct the airway more.”
The two experts agree that, given a loss of consciousness, the most urgent is and check if the person breathes. If you do not breathe, you have to start with cardiopulmonary resuscitation as soon as possible. “It is not always clear. Sometimes breathing is abnormal, slow, laborious … it is what we call an agonizing breathing, which occurs in some cases of cardiac arrest, where the victim makes air glasses, but in reality he does not breathe. Before the doubt, it is best to start the compressions,” insists blocks.
And an note about cardiac massage: it can be done. A study of the Clinic hospital found that following this song mentally increases the quality of chest compressions. Although it is also worth it Stayin’ aliveof the Bee Gees. Wave intro of spongebob. Any of them works to mark the frequency of the compressions: 120 per minute.
In Spain, recalls Fernández Lozano, the survival of a cardiac arrest in the street is 9%. In Holland, however, it is 30%. “We have stayed there and we do not advance. Spanish does not want to know anything about death and its health education is bad,” laments the cardiologist. And criticizes the difficulties in – “There is the tenth that in France” -, as well as the complexity of disassembling the myths installed.
The origin of myth
The origin of this myth about the danger of swallowing the tongue is not clear. In, a group of Canadian researchers suggests that it can go back to the first stories of epilepsy, “who proposed that loss of consciousness could cause obstruction of the respiratory tract due to the displacement of the tongue, although not to the real swallowing of the same,” they clarify. And they add that this erroneous idea has been able to perpetuate itself in popular culture thanks to films and series such as Someone flew over the cuckoo nest o Game of Throneswhere “the placement of objects in the mouth is dramatized to avoid the swallowing of the tongue during seizures,” the authors agree.
Another hypothesis that can feed this idea is also that in many cases of cardiac arrest, victims may present “activity similar to a seizure at the beginning”. It is a pattern that is frequently observed in heart strikes related to sport, they point out. So “it is understandable that this myth has moved to the public response to heart strikes in athletes,” although there are no clinical indications for such maneuver, they assume. In addition, signs such as cyanosis (blue skin coloration) and agonizing breathing can be confused with suffocation, which can lead citizens who meet such a picture “to prioritize the inspection of the respiratory tract before starting cardiopulmonary resuscitation.”
10 minutes without doing anything, zero survival
The big problem of all this is that these erroneous actions can delay vital interventions. “Every minute of delay in cardiopulmonary resuscitation, survival between 10% and 12% decreases,” synthesizes blocks. This means that, before a cardiac arrest, if we wait 10 minutes without doing anything ,. “On the other hand, if you act quickly, if defibrillation is done in the first five minutes after the stop, the probability of survival is 70%,” he abounds.
Missing health training in citizenship, the experts consulted agree. And the myth of swallowing the tongue is not the only one installed around cardiopulmonary resuscitation. Canadian researchers remember that another “common error” is to believe that “Sudden cardiac arrest is presented with known cardiovascular diseases or abnormalities, which leads to spectators in sports environments to overlook the first signs of cardiac arrest and underestimate the urgency of the intervention.” Another pilot barrier about the fear of causing damage or injuries, such as fracturing someone’s ribs during thoracic compressions, giving an inappropriate discharge with an automatic defibrillator or transmitting infections through mouth to mouth.
On the fears of harming, blocks is overwhelming: “It is more harmful to do nothing to harm them in a rib. If you do not do the resuscitation, the victim will not have an injury, but it will probably not be here to tell it either.”
