Breathing should not be the indicator of life

How can you tell if a person needs CPR? What if they are still breathing? Don’t be fooled by the breathing. Over the years we were taught not to do CPR if the person is breathing. A person requiring CPR will never be breathing at all, right? Wrong! It is important to understand agonal respirations. Agonal respirations occurs frequently in cardiac arrest victims, some studies indicate that it occurs as much as 65% of the time. If you don’t know what to look for it will trick you. So what is agonal respirations and why does this happen? Agonal breathing is also known as gasping for breath. It is a sign that the body is not receiving the oxygen it needs. Agonal breathing originates from the lower brain stem and is an automatic response due to inadequate oxygen, even though the person may be in cardiac arrest (and clinically dead) the brain stem is still sending messages to breathe. Agonal breathing can present as a snorting, snoring, gurgling or gasping sound. Some describe a fish out of water or attempts for gulps of air. The duration differs from person to person, usually lasting from a few seconds to a few minutes. Agonal breathing is irregular and sporadic. It is important to remember that agonal breathing is not sufficient in delivering oxygen to the body. It is a sign of distress and is therefore not considered real breathing.

Our goal is to start CPR immediately when Cardiac Arrest occurs, so what if we see this agonal respirations? Do not use breathing as your only guide to determining to provide CPR or not. We used to worry about starting CPR on someone who doesn’t necessarily need CPR. We used to check breathing, check pulse and other signs to be sure that compressions were the right thing. The studies out now suggest that if the person is unresponsive and not breathing normally then we should start CPR as the benefits far outweigh the risks. If you are doing compressions correctly (a full 2″ in depth for an adult) the victim WILL let you know if they don’t need it. We have complied a video that show what agonal respirations looks like. Keep in mind that agonal respirations can look different among individuals but just remember, agonal respirations will not look like normal breathing.

So how do you know when it is appropriate to begin CPR? A few things to look for when approaching a victim: First off assure that the scene is safe. Secondly tap the victim and loudly ask if they are OK (A sternal rub may be appropriate to weed thru the uncertainty) Visual look at the victim and check for “normal breathing” , skin color and purposeful body movement. If it’s an adult call (or send someone to call) 911 and get the defibrillator. Start CPR with compressions. Do not delay CPR. If the person doesn’t need CPR and your doing appropriate 2″ compressions, they will let you know, versus delaying CPR and potentially decreasing the patients chances of survival.

Agonal Respirations – Video

Do you know what to do in the event of a cardiac arrest? You can with training from Northwest Health and Safety Inc. Northwest Health and Safety Inc is the Northwest’s leading provider of CPR, First Aid and AED training programs serving the Vancouver, Washington and Portland Oregon areas. We provide corporate safety training to training for individuals all at low prices. Visit our course calendar for up coming trainings or contact us at 360-737-8910 or by email.