Compression Asphyxia Caused Astroworld Festival Deaths—Here's What That Is

In early November 2021, 10 people died in a crowd surge at the Astroworld Festival in Houston where singer Travis Scott performed. A few months later, public health officials announced that the victims all died from the same cause: compression asphyxia.

Medical examiners at Houston's Harris County Institute of Forensic Sciences had to wait several weeks after the concert to do additional tests before making a final determination on the cause of death, according to an updated report obtained by Health. The manner of the deaths has been ruled an accident, and the victims ranged in age from 9 to 27, the report stated.

What is compression asphyxia, and how can you recover from it, if at all? Critical care experts break it down.

What Is Compression Asphyxia?

To understand compression asphyxia, it's important to first go over how breathing works in your body. When you breathe in air through your nose or mouth, it enters the lungs. Your lungs then pull out the oxygen and send it through your blood vessels to your vital organs, like your brain and heart, according to the National Heart, Lung, and Blood Institute (NHLBI).

On a macro level, asphyxia is a condition that happens when your body is deprived of oxygen, Eric Adkins, MD, an emergency medicine physician at The Ohio State University Wexner Medical Center, told Health. Compression asphyxia happens "when there is an external force that is limiting the ability of the chest to expand and for air to get into the lungs," explained Dr. Adkins.

Fady Youssef, MD, a board-certified pulmonologist, internist, and critical care specialist at MemorialCare Long Beach Medical Center in Long Beach, Calif., compares this situation to an accordion that's stuck in place. "If you can't open your lungs, you can't breathe," Dr. Youssef told Health. "A lot of times, this is seen in big crowds when people are crushed. The patient is unable to take a breath."

Why Is Compression Asphyxia So Dangerous?

The human body can't handle being without oxygen for long. "We're talking about a couple of minutes," said Dr. Youssef. "Even several seconds can lead to damage in the absence of oxygen."

When someone has compression asphyxia, they have a buildup of carbon dioxide in their lungs (which you usually breathe out) and don't take in enough oxygen to help support their cells, said Dr. Adkins. "That can quickly lead to organ failure and brain death," added Dr. Adkins. "At some point in this, you pass out. And if the obstruction is not relieved, you die."

Compression asphyxia isn't always deadly, explained Dr. Youssef. "It would require immediate intervention and immediate medical attention to try to halt the damage."

The deaths prompted dozens of lawsuits against Scott and Astroworld, alleging that they didn't do enough to ensure that concert-goers would be safe, per The Hill.