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. 2025 May 7;18(1):92.
doi: 10.1186/s12245-025-00900-9.

Instantaneous rigor - the challenge of securing an airway in cardiac arrest: a case report

Michal Soták  1   2 , Tomáš Henlín  3 , Tomáš Tyll  3
Affiliations

Instantaneous rigor - the challenge of securing an airway in cardiac arrest: a case report

Michal Soták et al. Int J Emerg Med. .

Abstract

Cadaveric spasm, also known as instantaneous rigor, is a rare and poorly understood phenomenon characterized by immediate muscle rigidity at the moment of death or cardiac arrest. This can result in severe trismus, making conventional airway management impossible. We present a case of a morbidly obese patient who suffered a sudden cardiac arrest with instantaneous rigor, necessitating an urgent surgical cricothyrotomy. This report underscores the need for early recognition of this condition, rapid decision-making regarding airway management, and the importance of specialized training for emergency physicians, particularly in anatomically challenging scenarios.

Keywords: Cardiac arrest; Difficult airway; Emergency airway management; Instantaneous rigor; Surgical cricothyrotomy.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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References

    1. Lee JH, Jung KY. Emergency cricothyrotomy for trismus caused by instantaneous rigor in cardiac arrest patients. Am J Emerg Med. 2012;30(6):e10141–2. - PubMed
    1. Pirch J, Schulz Y, Klintschar M. A case of instantaneous rigor? Int J Legal Med. 2013;127(5):971–4. - PubMed
    1. Esnault P, Prunet B, Lacroix G, D’Aranda E, Gaillard Y, Boret H. Instantaneous rigor after fatal Pholcodine intoxication. Br J Clin Pharmacol. 2014;77(3):578–9. - PMC - PubMed
    1. Bedford PJ, Tsokos M. The occurrence of cadaveric spasm is a myth. Forensic Sci Med Pathol. 2013;9(2):244–8. - PubMed
    1. Okada Y, Narumiya H, Kobayashi N, Nishimura H, Kotani H, Koike K, et al. Survival after cardiac arrest with instantaneous rigorlike stiffness: A case report. Ann Emerg Med. 2019;73(4):393–6. - PubMed

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