Special guest reviewer- Eamonn Clarke

Spoiler alert! Possible spoilers for the Judge Dredd story from Prog 1772 ahead. You have been warned.

The Judge Dredd story Day of Chaos continues and the tension and pace are unrelenting. This is part 8 of the Eve of Destruction, written by John Wagner, art by Ben Wilsher, colours by Chris Blythe, and lettered by Annie Parkhouse.

Dredd and his fellow Judges are struggling to prevent the East-Meg agents from delivering the Chaos organism and infecting the inhabitants of Mega-City one. However they have captured Borisenko, the leader of the rogue Sov-Judges and they are interrogating him for information about a possible antidote.

There’s no further details about the organism in this prog so let’s talk about airways management. Borisenko tries to commit suicide by swallowing his own tongue and asphyxiating himself. (This is also how Hannibal Lector supposedly persuades Multiple Miggs to kill himself in The Silence of the Lambs). In this scene the medics struggle to establish an airway in order to keep Borisenko alive for further questioning. Meanwhile Dredd is interrogating another suspect.

The tongue is a huge muscle, the part we can see in our mouths is only the tip of the iceberg as it were. Contrary to popular belief it is not possible to “swallow your tongue”, and certainly you can’t consciously decide to do this. What can happen is that if you are unconscious the thick muscle can flop backwards and over the top of the trachea or windpipe. That is how people who are drugged or drunk can die from a blocked airway. You can see the problem in this cross-section diagram.

However this only happens to people who are unconscious. You can’t consciously do this, the tongue muscle won’t let you. Borisenko seems to be conscious because, although he is restrained, he is resisting the medics’ attempts to open his mouth. Using something to “prise his jaws open” as the Judges are trying in the above panel is a good way to damage teeth and gums but it won’t establish a safe airway. Presumably the medics here are not too bothered about damaging Borisenko’s mouth, they just want him alive. Prying someones’ teeth apart is also a good way to get yourself bitten but I suppose the Mega-City Judges are wearing fairly hefty looking gloves.

After failing to insert a Naso-Pharyngeal airway the medics resort to an emergency Tracheostomy. The anatomy and technique shown here by Ben Wilsher is fairly accurate, and a tracheostomy is a reliable method of  establishing an emergency airway if all else fails. One of the Judges notes that Borsisenko is breathing again although it appears the breathing tube is hooked up to a ventilator in which case the machine is breathing for him.

Interestingly, there are already versions of tracheostomy tubes which allow the patient to speak. I assume they will be perfected by 2132, or thereabouts, when this story is set.

There is some confusion about airways management in this Prog, however the Mega-City medics save themselves and their patient by establishing a successful and accurate tracheostomy so I’m going to give this a medical rating of 3.5 out of a possible 5 medic-droids.

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