In contrast, adequate gas exchange to support life requires inhalation as well. Phonation can occur with exhalation alone in the complete absence of inhalation by using the expiratory reserve volume that remains after a normal tidal breath is exhaled. George Floyd could have uttered those syllables repeatedly with small breaths that filled only the trachea and bronchi but brought no air to the alveoli, where actual gas exchange happens. Anatomical dead space is typically one third the volume of an ordinary breath. Normal speech only requires approximately 50 mL of gas per syllable-thus, stating “I can't breathe” would require 150 mL of gas. Only air that exceeds the volume of this dead space is conducted to the alveoli for gas exchange. When each breath is inhaled, air first fills the upper airway, trachea, and bronchi speech is generated here, but no gas exchange takes place in this anatomical dead space. The volume of an ordinary breath is approximately 400 to 600 mL. Here, we review basic respiratory physiology and highlight our role as clinicians and scientists in educating the public against relying on speech as a sign of adequate respiration-especially when this medical misconception is used to propagate injustice or violence. Although the medical community may suspect that vocalization does not guarantee adequate respiration, they may not be sufficiently familiar with the relevant physiology to allow them to speak with authority. The belief that a person's ability to speak precludes the possibility of suffocation is not true and can have fatal consequences. Mayor Hal Marx of Petal, Mississippi, posted on Twitter the following day, “If you can say you can't breathe, you're breathing.” Similar arguments were put forth by New York Representative Peter King and police officials in the wake of Eric Garner's death in 2014. On, George Floyd pleaded at least 16 times, “I can't breathe.” One officer in attendance nonetheless told bystanders, “He's talking. Re-posted from: Annals of Internal Medicine - 3 November 2020Ī Dangerous Myth: Does Speaking Imply Breathing?īy: Anica C.
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