Debunking a life-threatening myth: "Tongue swallowing prevention" maneuvers delay CPR and might contribute to brain injury or death for collapsed athletes
Analysis in the Canadian Journal of Cardiology exposes media-fueled misconceptions and an urgent need for immediate public and professional re-education
Elsevier
Philadelphia, July 30, 2025 – Despite widespread public health efforts, the dangerous myth of "prevention of tongue swallowing" continues to persist during cardiopulmonary resuscitation (CPR). New research in the Canadian Journal of Cardiology, published by Elsevier, exposes the mainstream and social media’s detrimental role in perpetuating this misconception, which often leads to critical delays in proper CPR for collapsed athletes.
Concern about “tongue swallowing” leads resuscitators to waste valuable time trying to remove the tongue from the airway path, rather than immediately initiating essential CPR procedures. The findings from this analysis underscore an urgent need for global public health campaigns to correct CPR myths and emphasize the importance of immediate chest compressions. The study systematically analyzed 45 cases of athletes collapsing during sports events (1990–2024) that were caught on video or documented online, focusing on initial resuscitation actions and corresponding media coverage.
Commenting on the main findings of the analysis, lead investigator of the article "The Myth of “Tongue Swallowing” Delays Cardiopulmonary Resuscitation of Athletes With Cardiac Arrest, Yet It Is Often Perpetuated by the Media" Dana Viskin, MD, Department of Cardiology, Tel Aviv Sourasky Medical Center and School of Medicine, Tel Aviv University, says, “Our analysis showed that in 84% of cases where the initial response was visible, inappropriate maneuvers to ‘prevent tongue swallowing’ were performed before proper CPR. These incorrect actions were significantly associated with poor outcomes: 67% of those receiving such maneuvers died or had severe brain injury, compared to 0% when CPR was the first response.”
Media analysis revealed that nearly half (48%) of high-exposure news articles explicitly used the term “tongue swallowing,” with most praising the lay responder for their actions. In articles describing sudden cardiac arrest (SCA) cases, 77% referenced “tongue swallowing” without acknowledging its inappropriateness as a response to SCA, yet only 23% explicitly criticized the intervention.
“Given that some SCA patients, particularly young males with shockable arrest rhythms, may exhibit seizure-like activity at onset – a pattern frequently observed in sports-related SCA – it is understandable how this myth may have carried into the public response to athletic SCA, despite the absence of clinical guideline support for such an intervention,” points out the author of the accompanying editorial "Countering Misinformation in the Response to Sudden Cardiac Arrest in Athletes" Nicholas Grubic, MSc, Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto. “Furthermore, signs such as cyanosis and agonal respirations can be mistaken for choking, often prompting bystanders to prioritize airway inspection over initiating CPR. Recent qualitative research has confirmed that such misinterpretations can delay or even interrupt life-saving interventions. Although promoting CPR and automated external defibrillator (AED) knowledge remains a cornerstone of SCA education, teaching the public to recognize the early signs of an arrest is equally critical, as every second without action drastically reduces the chance of survival.”
This research is especially important now, as public CPR education becomes increasingly vital with widespread media exposure to cardiac arrests in sports.
"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," emphasizes Dr. Viskin.
Mr. Grubic adds in conclusion, “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. Responding to SCA is a team sport that starts with proper education to ensure that everyone is ready to step in, stay focused, and act. Although the prize is not a trophy, it is something much more valuable.”
Journal
Canadian Journal of Cardiology
Method of Research
Data/statistical analysis
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
Article Publication Date
30-Jul-2025
Developing next-generation analytical technique for gene and cell doping and ensuring ethics and fairness in sports
Using gene scissors to develop a rapid gene and cell doping detection test
image:
Gene and cell doping typically utilizes genes that encode proteins that can enhance athletic performance, and can evade current protein-level drug monitoring anti-doping tests.
view moreCredit: Korea Institute of Science and Technology(KIST)
Changmin Sung, a principal researcher at the Doping Control Center at the Korea Institute of Science and Technology (KIST), announced that he and his collaborators at the Department of Biomedical Engineering at Korea University have developed a high-throughput multiplexed gene and cell doping analysis (HiMDA) based on gene scissors (CRISPR-Cas).
Unethical doping practices to enhance athletic performance is becoming more sophisticated with the use of advanced technology, and gene and cell doping - the use of gene or cell therapies to manipulate body functions - poses a serious threat to fairness in sports. Gene-based drugs such as insulin-like growth factor (IGF-I) and erythropoietin (EPO), which can maximize strength and endurance, are likely to be abused by athletes in some sports as a means of performance enhancement. The World Anti-Doping Agency (WADA) has prohibited this practice since 2003, but diagnostic techniques that can accurately identify gene and cell doping are still in early stage.
Quantitative polymerase chain reaction (qPCR)-based gene testing has been piloted at the Tokyo Summer Olympics since the World Anti-Doping Agency first published guidelines for genetic doping in 2021. Current protein-level doping analytical methods cannot clearly distinguish between exogenous genetic targets that produces proteins structurally identical to endogenous proteins. This has led to the need for new analytical platforms that can distinguish exogenous genes at the DNA level.
The HiMDA directly amplifies the target gene from the blood without complex sample preparation, and then applies CRISPR-Cas, the Nobel Prize-winning gene editing technology to determine the presence of the exogenous gene rapidly and precisely. By injecting representative gene doping substances such as hGH, EPO, IGF-I into an experimental mouse model and applying the assay platform, the researchers were able to accurately detect exogenous genes at the 2.5 copies within 90 minutes using as little as 5 μL (microliters) of blood sample, less than half the size of a fingertip drop. This demonstrated superior performance in both sensitivity and specificity compared to existing assays.
The developed assay is not limited to doping tests, but is considered to be a platform-based diagnostic technology that can be applied to early diagnosis of infectious diseases, detection of antibiotic resistance genes, genetic disease testing, evaluation of cell therapy drug adaptability, and precision medicine. Currently, the technology is undergoing the certification process to be adopted as a World Anti-Doping Agency-approved method, and is attracting attention as a next-generation anti-doping testing platform that can respond to various new doping methods based on genes and proteins.
"By applying gene editing technology to doping tests, this study provides a practical solution that can overcome the limitations of existing techniques and contribute to protecting sports ethics and fairness," said Changmin Sung, a principal researcher at KIST. "It has the potential to develop into a core foundation for precision medicine and genetic diagnostic technologies in the future."
Very trace amounts of doping genes and transgenic cell models spiked in blood are amplified directly without nucleic acid extraction, and the presence or absence of targets is then confirmed by sequence-dependent fluorescence reaction of Cas12a, a type of gene scissors. The entire analysis time from blood to readout is as short as 90 minutes.
The advantage is that doping genes in blood can be amplified without nucleic acid extraction, reducing the time and labor required for extraction. This allows multiple blood samples to be processed simultaneously for high-throughput processing and analysis.
The advantage is that doping genes in blood can be amplified without nucleic acid extraction, reducing the time and labor required for extraction. This allows multiple blood samples to be processed simultaneously for high-throughput processing and analysis.
Credit
Korea Institute of Science and Technology(KIST)
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KIST was established in 1966 as the first government-funded research institute in Korea. KIST now strives to solve national and social challenges and secure growth engines through leading and innovative research. For more information, please visit KIST’s website at https://www.kist.re.kr/eng/index.do
This research was supported by the Ministry of Science and ICT (MSIT) under the KIST Institutional Program and the World Anti-Doping Agency Research Support Program (241E07CS). The findings were published in the latest issue of the international journal Science Advances (IF 12.5, JCR top 8.5%).
Journal
Science Advances
Article Title
High-throughput multiplexed gene and cell doping analysis through CRISPR-Cas12a system integrated with blood direct PCR
Article Publication Date
29-Jul-2025
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