Agonal Breathing: A Critical Indicator of Cardiac Arrest

Agonal breathing is an abnormal pattern of respiration that can be an early warning sign of cardiac arrest. Understanding how to quickly identify and respond to agonal breathing could help save someone’s life. This guide covers everything you need to know about these distressed breaths and what to do when they occur.

What is Agonal Breathing?

Agonal breathing refers to irregular, gasping breaths that happen during cardiac arrest. It is the body’s automatic reflex as the heart stops pumping adequate blood to the brain and vital organs.

These sporadic gasps may persist for several minutes after someone loses consciousness. Agonal breaths sound like snorting, gurgling, or moaning noises. The chest may appear to rise and fall.

Agonal breathing should not be confused with normal breathing. It does not represent adequate oxygen intake. Agonal respiration indicates a dire emergency requiring immediate medical intervention.

Key Signs of Agonal Breathing

Watch for these symptoms of agonal breathing in someone who is unresponsive:

  • Sporadic, infrequent gasping breaths
  • Abnormal snoring or gurgling sounds
  • Slow, irregular chest movements
  • Blue skin colour (cyanosis) due to oxygen deprivation
  • No pulse palpated
  • Dilated pupils unreactive to light

Compare agonal breathing to the normal respiratory rate of 12-20 breaths per minute in adults. Agonal gasps occur only 2-3 times per minute or slower. The breathing pattern is markedly abnormal.

Agonal Breathing as a Sign of Cardiac Arrest

Agonal respiration most commonly occurs during sudden cardiac arrest. When the heart stops pumping blood effectively, delivery of oxygen to the brain is compromised.

The agonal gasps represent the brain stem’s instinctive but ineffective attempt to recommence breathing. Without prompt defibrillation and CPR, respiratory arrest follows.

Agonal breathing can also arise from:

  • Drowning
  • Stroke
  • Drug overdose
  • Asphyxiation
  • Exsanguination (severe bleeding)

Any medical emergency impairing oxygenation of the brain can trigger agonal breathing before complete respiratory failure.

Responding to Agonal Breathing

Recognising agonal respiration allows bystanders to initiate potentially lifesaving interventions for cardiac arrest. Follow these steps if you see agonal breathing:

  1. Check for consciousness. Shake the shoulder and shout.
  2. If no response, call emergency services immediately.
  3. Begin chest compressions. Push hard and fast in the centre of the chest.
  4. Follow dispatcher instructions. They may advise you to retrieve and use an AED.
  5. Continue CPR until paramedics arrive.

Even with agonal gasps, do not assume the person is getting adequate oxygen. Start CPR immediately and use an automated external defibrillator (AED) as soon as possible to restore a perfusing heart rhythm.

Early bystander intervention can dramatically improve survival odds in cardiac arrest. Acting quickly when you spot agonal breathing gives the victim the best chance of recovery with minimal neurological consequences.

Improving Recognition of Agonal Breathing

Bystander response is hindered when people mistake agonal respiration for normal breathing. Education is key to improving recognition and response.

You can help save lives by learning the signs of agonal breathing and sharing them with others. Taking CPR/AED certification courses also prepares you to take action in an emergency.

Fast action can save more lives from sudden cardiac arrest through proper identification and response to agonal breathing. Stay alert to this critical warning sign and be ready to perform lifesaving interventions while awaiting paramedic arrival.

Agonal Breathing Simulation

The video below showcases an actor simulating a cardiac arrest and agonal breathing.