The common phrase “swallowing one’s tongue” describes a serious medical event, though it is physiologically inaccurate. The tongue cannot be literally swallowed due to its anatomical attachments. Instead, the phrase refers to a real and potentially life-threatening situation: the tongue obstructing the airway. This article explains the mechanism of this obstruction, its causes, and how to respond.
The Tongue’s Role in Airway Obstruction
The human tongue is a muscular organ firmly anchored to the floor of the mouth. This makes it impossible for the tongue to detach or be “swallowed” into the throat. However, in states of unconsciousness or profound muscle relaxation, the muscles that support the tongue and maintain the patency of the upper airway lose their tone.
When these muscles relax, the tongue can fall backward against the posterior wall of the pharynx. This backward movement of the tongue, along with the relaxation of other soft tissues, can partially or completely block the passage of air to the lungs. This mechanical obstruction prevents adequate breathing, creating the appearance of the tongue being “swallowed.”
Situations Leading to Airway Blockage
Airway obstruction due to tongue relaxation occurs in conditions that cause a loss of consciousness or significant muscle control. Such scenarios include head trauma, where the brain’s ability to maintain muscle tone is compromised. Epileptic seizures are another cause, as the intense muscle activity followed by profound relaxation can lead to the tongue falling back and obstructing the airway.
Drug overdose and alcohol intoxication also depress the central nervous system, leading to widespread muscle relaxation, including those controlling the airway. Other medical conditions, like obstructive sleep apnea, involve similar mechanisms where relaxed throat muscles cause the tongue to slide back and block breathing during sleep. When the airway remains blocked, the body experiences oxygen deprivation, known as hypoxia. This lack of oxygen can rapidly lead to brain damage and impact other organs, requiring prompt intervention.
Responding to Airway Obstruction
If someone appears to have an obstructed airway due to an unresponsive state, immediate action is needed. The first step involves calling emergency services. While waiting for professional help, positioning the person correctly can help open the airway. The recovery position is a first-aid technique for unconscious but breathing individuals, designed to prevent the tongue from falling back and allow any fluids to drain from the mouth.
To place someone in the recovery position, kneel beside them, extend the arm closest to you at a right angle to their body, and bring their other arm across their chest with the back of their hand against the cheek closest to you. Bend the far knee, then gently roll the person onto their side towards you, supporting their head and neck. Never attempt to put fingers or any objects into the person’s mouth, especially during a seizure, as this can cause injury to the person and rescuer, and is ineffective in clearing the airway. If safe, check for and remove any visible obstructions from the mouth.