You may have read about what happened yesterday in Itaewon, South Korea. 82 people were injured, 19 seriously, and 151 died when thousands were packed in a sloped and narrow alley.
In a CNBC report, Choi Sung-beom, head of the Yongsan Fire Station, said that many victims were women in their 20s.
It was the first Halloween event in Seoul in three years after the country lifted Covid-19 restrictions and social distancing.
As early as 24 hours before the event, there were warning signs that the festivities were attracting too many people.
Victims and their relatives questioned an apparent lack of crowd control.
Witnesses described the crowd becoming increasingly unruly and agitated as the evening deepened. Chaos erupted just before the 10:20 p.m. (1320 GMT) stampede.
Choi, the Yongsan district fire chief, said all the deaths were likely from the crush in the alley.
In the video below, Mmariposa said, “Look at this. It is brutal #Itaewon I would not have endured so much suffering. Looks like a horror movie.”
Notice the screaming girl on the left of the man in the middle (your right). At the 28-second mark, she became quiet and passed out.
Vean esto. Está brutal lo de #Itaewon Yo no hubiera soportado tanto sufrimiento. Parece película de terror. #SouthKorea pic.twitter.com/A8RCW1pJp7
— M͓̽M͓̽A͓̽R͓̽I͓̽P͓̽O͓̽S͓̽A͓̽ (@MMariposa31) October 29, 2022
Compression asphyxia is when excessive levels of external pressure are applied to the chest and abdomen to prevent their movement for breathing.
Patent upper airways and clear lungs are not enough to breathe. The lungs should be able to expand. That is made possible by the movement of the ribs and the diaphragm.
The video below shows the movement of the ribs and the diaphragm during inhalation.
The abdominal muscles can also be used for breathing. The outward movement of the abdominal wall allows the diaphragm to go down, expand the lungs vertically and draw air in.
Abdominal breathing is demonstrated in the video below.
Abdominal breathing is used during meditation to pull air into the Hara, or the space near the pelvic area.
In the Twitter video, the girl was screaming as loud as she could. That act did three things. One, it increased the adrenaline. Two tensed her muscles, and three increased the oxygen consumption of the whole body.
Higher oxygen use depletes oxygen reserves from the blood and increases oxygen demand or air hunger. That will trigger a reflexive act to increase the rate of breathing.
She was also screaming. This made her exhale more, which contracted her chest and further decreased the space for her lungs. The contracted chest allowed the people against her to press some more.
That limits the space for her chest to expand on the next breath. Thus, her next breath is shallower than her previous. The blood oxygen level continues to drop until her brain cannot maintain consciousness, which makes her pass out.
Once unconscious, no one can make a forceful inhalation anymore, and death slowly creeps in.
Irreversible brain damage happens if the brain does not get any oxygen for five minutes.
So how do you prevent compression asphyxia?
Avoid potentially or already crowded spaces.
In Itaewon, as early as the day before, there were ten times more people than usual.
Go to higher ground or a safe space.
If it feels like the space is getting limited or the crowd is getting unruly, inch your way out of the middle and go to the periphery or inside a building.
If you can climb a tree or step on something stable, that will prevent you from getting squeezed by the crowd.
Assume a defensive position.
Here is what I would do if I were in a stampede and had nowhere to go.
Like in the photo above, I would brace my upper arms with my hands. This position will protect the sides of my chest against excessive pressure and still allow lateral movement of the chest for breathing.
The folded arms allow your abdominal wall to expand forward for abdominal breathing.
In Zen breathing, you imagine bringing the air to the area below your belly button. This is made possible by expanding your abdominal wall outwards. That motion will pull the diaphragm lower and expand the lungs vertically to make inhalation possible, like in the second YouTube video (Diaphragm breathing) above.
The shoulders and arms should be relaxed and not try push outwards. That will spend energy unnecessarily. While assuming this position, I will slowly move away from the deadly crowd.
It should be done in a relaxed state. I know that is easier said than done, but it is essential not to lose composure at that moment.
Martial arts training and sparring can help anyone cope with a stressful situation.
Don’t Get Squished!
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References:
- Gill et al. Traumatic Asphyxial Deaths Due to an Uncontrolled Crowd. Am J Forensic Med Pathol 2004;25: 358 –361
- Sun L, Badler NI. Exploring the Consequences of Crowd Compression Through Physics-Based Simulation. Sensors (Basel). 2018 Nov 27;18(12):4149. doi: 10.3390/s18124149. PMID: 30486340; PMCID: PMC6308419.
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