Experts warn airway-first CPR delays may endanger athletes

Experts caution that prioritising airways before chest compressions during on-field cardiac arrests can delay life-saving treatment for athletes, with researchers urging immediate cardiopulmonary resuscitation and early defibrillation to reduce the risk of death.

Dr Dana Viskin of Tel Aviv University said the first response “should be immediate initiation of chest compressions”, noting that while paralysis or total relaxation of the tongue’s main muscle can obstruct the airway and lead to suffocation, the tongue itself is anchored by muscles and ligaments and cannot be swallowed.

Writing in the Canadian Journal of Cardiology, Viskin and colleagues analysed online footage of athlete collapses from 1990 to 2024 and reviewed high-visibility news articles to characterise initial responses and the spread of the “tongue swallowing” myth.

Across the record: 45 identified cases (1990–2024) with first actions visible in 38; 30 cardiac arrests of which 27 began with “inappropriate” actions such as forcing open the mouth, 18 of those 27 known to end in death or a vegetative state, and none of the three athletes who received CPR as the first response having such outcomes; the Euro 2020 incident in 2021 involving Denmark’s Christian Eriksen is cited.

The team said airway–breathing–circulation teaching may have unintentionally promoted the myth, pointing out that American Heart Association guidelines effectively reordered the steps to C-A-B in 2010 to emphasise compressions.

A spokesperson for the College of Paramedics said the public should follow Resuscitation Council UK guidance by starting chest compressions and calling 999 if a person is unconscious, unresponsive and not breathing or breathing noisily, adding that trained teams prioritise compressions while another professional manages the airway.

“A quick response – especially chest compressions and early defibrillation – is critical,” Viskin said, stressing that time spent checking the airway or trying to prevent so-called “tongue swallowing” only postpones essential care.

30 July 2025 10:18 By London Health News Desk