Being knocked out and "swallowing your tongue"
Discussion
There have been two knockouts on the football field reported in the media recently, one in Czech Republic, and last night was Fernando Torres. Both made a big deal that teammates (and opposition) "saved their lives" by preventing them from swallowing their tongue.
I always thought a) you can't actually swallow your tongue, and b) the way to prevent a tongue blocking a person's airway (which can happen) is by carefully (due to potential spinal injry), positioning the head, jaw and person's body correctly and you don't need to fish about inside their mouth.
This sort of thing annoys me this as I have a good friend who is epileptic, and she complains that on the rare occasion she had a seizure in public, people's first concerns are to stick their fingers, spoons, rolled up newspapers etc in her mouth to prevent her swallowing her tongue when just being put in a safe recovery position is enough.
I always thought a) you can't actually swallow your tongue, and b) the way to prevent a tongue blocking a person's airway (which can happen) is by carefully (due to potential spinal injry), positioning the head, jaw and person's body correctly and you don't need to fish about inside their mouth.
This sort of thing annoys me this as I have a good friend who is epileptic, and she complains that on the rare occasion she had a seizure in public, people's first concerns are to stick their fingers, spoons, rolled up newspapers etc in her mouth to prevent her swallowing her tongue when just being put in a safe recovery position is enough.
The recovery position is designed to prevent an unconscious person swallowing their tongue, or choking on their own vomit. And the reason the head's tipped back when doing mouth-to-mouth is to clear the tongue from the airway.
Both of these involve moving the spine/neck, but certain death from asphyxiation vs. the potential of aggravating a spinal injury is a bit of a no-brainer.
Both of these involve moving the spine/neck, but certain death from asphyxiation vs. the potential of aggravating a spinal injury is a bit of a no-brainer.
You're absolutely right. The tongue doesn't get 'swallowed'. It's a lazy myth with some basis in reality, along the lines of what you've said.
In unconsciousness the tongue falls back, and the structures of the soft palate relax, occluding the airway. This occlusion may not be complete - both silence and snoring indicate the need to inspect open and maintain the airway in any unconscious casualty.
The two manual airway manouevres recommended are the chin lift, and the jaw thrust if there is high suspicion of c-spine injury (falls, collisions, other significant impact). The airway clearly must always take priority over care for spinal injury.
The recovery position can also be considered an airway opening manouevre, and has the additional benefit of allowing 'postural drainage': blood and other fluids can freely drain away. As you say, very useful in the management of someone having a seizure. In reality, getting them on their side with their airway forward and down, and their head protected from impact with the ground is often the best you can do, but that will work.
Could elaborate further but those are the basics and if you want much more info an accredited training provider would be the way ahead.
Luke
In unconsciousness the tongue falls back, and the structures of the soft palate relax, occluding the airway. This occlusion may not be complete - both silence and snoring indicate the need to inspect open and maintain the airway in any unconscious casualty.
The two manual airway manouevres recommended are the chin lift, and the jaw thrust if there is high suspicion of c-spine injury (falls, collisions, other significant impact). The airway clearly must always take priority over care for spinal injury.
The recovery position can also be considered an airway opening manouevre, and has the additional benefit of allowing 'postural drainage': blood and other fluids can freely drain away. As you say, very useful in the management of someone having a seizure. In reality, getting them on their side with their airway forward and down, and their head protected from impact with the ground is often the best you can do, but that will work.
Could elaborate further but those are the basics and if you want much more info an accredited training provider would be the way ahead.
Luke
MurderousCrow said:
You're absolutely right. The tongue doesn't get 'swallowed'. It's a lazy myth with some basis in reality, along the lines of what you've said.
In unconsciousness the tongue falls back, and the structures of the soft palate relax, occluding the airway. This occlusion may not be complete - both silence and snoring indicate the need to inspect open and maintain the airway in any unconscious casualty.
The two manual airway manouevres recommended are the chin lift, and the jaw thrust if there is high suspicion of c-spine injury (falls, collisions, other significant impact). The airway clearly must always take priority over care for spinal injury.
The recovery position can also be considered an airway opening manouevre, and has the additional benefit of allowing 'postural drainage': blood and other fluids can freely drain away. As you say, very useful in the management of someone having a seizure. In reality, getting them on their side with their airway forward and down, and their head protected from impact with the ground is often the best you can do, but that will work.
Could elaborate further but those are the basics and if you want much more info an accredited training provider would be the way ahead.
Luke
So really all a bit of melodrama (as usual? In unconsciousness the tongue falls back, and the structures of the soft palate relax, occluding the airway. This occlusion may not be complete - both silence and snoring indicate the need to inspect open and maintain the airway in any unconscious casualty.
The two manual airway manouevres recommended are the chin lift, and the jaw thrust if there is high suspicion of c-spine injury (falls, collisions, other significant impact). The airway clearly must always take priority over care for spinal injury.
The recovery position can also be considered an airway opening manouevre, and has the additional benefit of allowing 'postural drainage': blood and other fluids can freely drain away. As you say, very useful in the management of someone having a seizure. In reality, getting them on their side with their airway forward and down, and their head protected from impact with the ground is often the best you can do, but that will work.
Could elaborate further but those are the basics and if you want much more info an accredited training provider would be the way ahead.
Luke
) From the footballers?prand said:
So really all a bit of melodrama (as usual? ) From the footballers?
Haha! In this case, arguably not. Airway obstruction is an emergency. ) From the footballers?If one of these unconscious footballers were left on their back with an occluded airway for long enough, yes they’d die.
Airway obstruction due to depressed levels of consciousness happens quickly and easily. Recognising it and dealing with it can certainly be considered a life-saving act.
That said, it's the kind of skill your average four-year-old could manage. Raising awareness of how to recognise and manage an obstructed airway has to be a good thing but at the basic levels it's hardly a deeply technical thing to do.
Edited to add:
Just found an article for the event in question.
http://www.independent.co.uk/sport/football/europe...
Yes it's melodramatic. The guy wasn't going to die in seconds. You don't put your fingers in the casualty's mouth unless you can clearly see a foreign body in there... While well-intentioned, it sounds like the rescuing player gets a bit over-excited when people get knocked out around him:
'“It has been four times. Once in Thailand and twice in Africa," the former Honved striker told reporters after the game.'
Arguably the second player in the number 3 shirt has a more realistic appreciation of what's required. Still, a lot better than just walking off!
Edited to add:
Just found an article for the event in question.
http://www.independent.co.uk/sport/football/europe...
Yes it's melodramatic. The guy wasn't going to die in seconds. You don't put your fingers in the casualty's mouth unless you can clearly see a foreign body in there... While well-intentioned, it sounds like the rescuing player gets a bit over-excited when people get knocked out around him:
'“It has been four times. Once in Thailand and twice in Africa," the former Honved striker told reporters after the game.'
Arguably the second player in the number 3 shirt has a more realistic appreciation of what's required. Still, a lot better than just walking off!
Edited by MurderousCrow on Friday 3rd March 17:50
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