Philadelphia, July 30, 2025 – New research published in the Canadian Journal of Cardiology reveals a persistent and perilous myth surrounding cardiopulmonary resuscitation (CPR) for athletes experiencing sudden cardiac arrest (SCA). The myth, widely known as the “prevention of tongue swallowing,” continues to misguide both lay responders and media narratives despite overwhelming evidence disproving its validity. This misconception has led to critical delays in initiating proper life-saving measures, notably immediate chest compressions, which are essential to improve survival outcomes during cardiac emergencies on the field.
The study, led by Dr. Dana Viskin from the Department of Cardiology at Tel Aviv Sourasky Medical Center and Tel Aviv University’s School of Medicine, systematically reviewed 45 cases of athlete collapses captured on video or documented online between 1990 and 2024. The analysis focused on initial resuscitation responses and the portrayal of these events in mainstream and social media outlets. It found that in approximately 84% of visible initial response scenarios, bystanders performed unnecessary and inappropriate maneuvers aimed at “preventing tongue swallowing” before commencing proper CPR. This behavior was strongly associated with significantly worse clinical outcomes.
Cardiopulmonary resuscitation fundamentally depends on the immediate restoration of circulation through chest compressions. The myth of tongue swallowing suggests that collapsed individuals can somehow “swallow their tongue,” obstructing the airway and necessitating manual removal attempts. However, this concept is anatomically and clinically inaccurate. The tongue, anchored to the floor of the mouth, cannot be swallowed. Instead, what often occurs is tongue relaxation and posterior displacement, which can contribute to airway obstruction. Yet, the recommended response is to promptly initiate chest compressions and open the airway using recognized techniques rather than attempting risky and time-consuming tongue manipulation.
The research highlighted a stark contrast in outcomes related to resuscitation responses. In cases where misguided interventions occurred first, 67% of patients either died or suffered severe neurological injuries. Conversely, when CPR was started immediately, without prior futile airway maneuvers targeting the tongue, none of those cases resulted in death or severe brain damage. These findings underscore the vital importance of adhering to established resuscitation guidelines and the dangerous consequences of misinformation.
Media coverage itself plays a significant role in perpetuating this harmful myth. The investigators’ content analysis of media reports found that nearly half (48%) of widely disseminated news articles explicitly used the term “tongue swallowing.” Many such reports applauded the efforts of lay rescuers for their “heroic” attempts to prevent tongue swallowing despite lacking scientific basis. Only a minority of these accounts (23%) explicitly criticized the ineffective or inappropriate nature of these maneuvers. This media narrative inadvertently validates hazardous practices and obstructs efforts to educate the public accurately.
One contributing factor to this misconception relates to the clinical presentation of sudden cardiac arrest, which can sometimes mimic seizures, especially in young male athletes with shockable rhythms. Early SCA may include convulsive-like activity and signs such as cyanosis (bluish discoloration due to lack of oxygen) and agonal respirations (gasping breaths). These manifestations are commonly misinterpreted by untrained bystanders as choking or airway obstruction, prompting them to prioritize airway inspection over the critical need for immediate chest compressions.
Nicholas Grubic, MSc, from the Division of Epidemiology at the Dalla Lana School of Public Health, University of Toronto, emphasized that these misinterpretations delay or interrupt life-saving CPR interventions, significantly reducing chances of survival. In his accompanying editorial, he advocates for enhanced public health education that not only promotes CPR and automated external defibrillator (AED) training but also focuses on accurately recognizing the early signs of cardiac arrest. Public understanding of these clinical cues is paramount because every moment of inaction during SCA diminishes the likelihood of favorable outcomes.
From a physiological standpoint, the priority in sudden cardiac arrest is to restore effective circulation and oxygen delivery to vital organs, especially the brain. Delays caused by misguided efforts attempting to “pull out the tongue” waste precious seconds during which hypoxic brain injury develops. The current international resuscitation guidelines emphasize the “CAB” sequence—Circulation, Airway, Breathing—prioritizing chest compressions immediately after collapse recognition. This approach is supported by the pathophysiology of cardiac arrest and clinical evidence demonstrating improved survival with rapid initiation of compressions.
Despite these established protocols, the entrenched myth remains a global public health problem, partly fueled by sensational media portrayals and inadequate CPR training that sometimes omit critical clarifications. The study’s authors call for an urgent overhaul of CPR education programs worldwide, insisting on clear messaging that dispels the tongue swallowing myth. This includes embedding updated guidance into media reporting standards to prevent the inadvertent glorification of counterproductive maneuvers.
Moreover, coordinated communication initiatives involving academic institutions, healthcare organizations, and media professionals are necessary to reshape public perception and practice. Social media platforms, where misinformation can rapidly amplify, should be leveraged as tools for disseminating correct, evidence-based resuscitation information. Tailored campaigns aimed at sports communities, coaches, athletes, and spectators could be particularly impactful, given the prominence of SCA incidents in athletic settings.
The implications of this research extend beyond sports arenas. Sudden cardiac arrests occur in diverse environments and populations, making the accurate public understanding of CPR vital for saving countless lives. By confronting myths head-on and fostering scientifically grounded knowledge, the global community can enhance bystander intervention effectiveness, reduce preventable deaths, and improve neurological outcomes after cardiac emergencies.
Dr. Viskin’s remarks encapsulate the study’s urgent message: “Our study highlights the dangerous and persistent misconception of ‘tongue swallowing prevention,’ which can delay the initiation of life-saving chest compressions. These delays may cost lives, and yet the media often praise such misguided actions as heroic. We urgently need to re-educate the public and the media and reframe the narrative around CPR, especially in sports.”
Mr. Grubic further insists that “coordinated, evidence-informed communication strategies are essential to counter misinformation and support public understanding, particularly in high-stakes situations such as the response to SCA in athletes. Our public capacity to save lives should not be impeded by misinformed voices – now is the time for the academic, healthcare, and media sectors to join forces and build a healthier information environment for all.”
As the frequency of televised and viral sports events continues to rise, so does the imperative to refine how cardiac emergencies are portrayed and addressed in real-time. Scientific accuracy, clarity in public messaging, and robust CPR training are the cornerstones for turning the tide against deadly myths. The fight against sudden cardiac arrest is, indeed, a team effort – one that depends on knowledge, decisiveness, and above all, speed.
Subject of Research: People
Article Title: The Myth of “Tongue Swallowing” Delays Cardiopulmonary Resuscitation of Athletes With Cardiac Arrest, Yet It Is Often Perpetuated by the Media
News Publication Date: 30-Jul-2025
Web References:
- Canadian Journal of Cardiology
- Article DOI: 10.1016/j.cjca.2025.06.002
- Editorial DOI: 10.1016/j.cjca.2025.07.001
Keywords: Sudden Cardiac Arrest, CPR, Tongue Swallowing Myth, Athlete Safety, Bystander Response, Media Misinformation, Chest Compressions, Cardiology, Public Health Education, Resuscitation Guidelines, Cardiac Arrest Recognition, Sports Medicine
