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Can You Perform CPR When Someone Is Experiencing Agonal Breathing?

Can you perform CPR when someone is experiencing Agonal breathing

We’ll be breaking down everything you need to know about performing CPR on someone with agonal breathing, and whether it should be done or not. Even if you have a CPR certification. Cardiopulmonary resuscitation is one of the first and most common life-saving techniques used and taught at school or work. It’s a technique invented and started being used back in the 16th century – and it has one of the most important places in emergency life-saving to this day. 

There are certain criteria to be met before giving CPR, such as making sure the victim isn’t breathing or has an irregular heartbeat. The same goes for persons with agonal breathing. 

It is true that people with agonal breathing can receive CPR to increase their chances of survival. However, circumstances always matter, and in some cases, agonal breathing has a different cause other than cardiac arrest.

Below, we explain what agonal breathing is, the signs, the main causes, and how CPR may help in some cases.

What Is Agonal Breathing and Should You Perform CPR?

‘Agonal’ is a medical term used to refer to the “last breath” – the gasping sound when the body is choking and in need of air. This happens when the blood supply to the brain is cut off, causing the person to start gasping for air. Because we get oxygen from the cells in our blood, resuscitating the victim and returning their normal oxygen supply is vital.

Agonal aspiration is an airway obstruction caused due to a serious medical condition, such as the following ones:

Heart Attack 

A heart attack is more likely to lead to cardiac arrest, which is a condition more similar to arrhythmia – the irregular functioning of the heart. A heart attack, on the other hand, is caused due to irregular blood flow due to arterial narrowing, preventing the quality and quantity of blood flow that reaches the heart muscle.  

Hemorrhagic Stroke 

A hemorrhagic stroke happens inside the brain, and is usually caused by a bleeding heart vessel, which prevents the regular flow of oxygen. This can be dangerous because it can leave irreversible damage to the brain and regulatory functions, depending on how much time the brain was left without oxygen.

Cardiac Arrest

Cardiac arrest is the most common condition that can lead to agonal breathing, which happens in 40% of out-of-hospital cardiac arrest victims. This is because the disruption of the heartbeat leads to respiratory distress, forcing the lower brainstem to cause a non-voluntary breathing reflex. 

Cerebral Ischemia

Cerebral ischemia is a common cause of agonal breathing that occurs due to reduced blood flow inside the brain, usually because of a ministroke. The limited oxygen supply can lead to the death of certain brain tissues, as well as a cerebral infarction. 

Common Symptoms of Agonal Breathing

Due to the many possible conditions leading to agonal breathing, the common symptoms are not always consistently presented. However, here are some of the most occurring ones:

  • Deep breathing
  • Abnormal respirations
  • Gasping
  • Snorting
  • Moaning
  • Sporadic breathing
  • Headaches
  • Slurred speech
  • Unconsciousness
  • Inability to understand others 
  • Inability to respond to external triggers
  • Limpness in one half of the body
  • Droopy face.

In most cases, people with agonal breathing can be conscious for seconds, minutes, and, very rarely, hours before they collapse. So, tracking the person’s breathing patterns is the best way to ensure they may be experiencing a heart attack or cardiac arrest.

According to medicine, when a person has a respiration rate of less than 12 or more than 25 breaths per minute, they have a disrupted breathing pattern and are experiencing agonal breathing. On the other hand, the average adult usually takes between 12-20 breaths per minute. 

How Can CPR Help Victims Experiencing Agonal Breathing? 

For a person with agonal respiration, every second matters. So, the victim has decreased survival chances for each second their body goes without a heartbeat or proper oxygen supply in some body parts, including the brain. 

Even if the victim survives, if they are left for several minutes without a proper oxygen supply, the possibility of brain damage is high.

Patients can struggle with agonal breathing for less than 5 minutes, but they may also end up breathing abnormally for hours. According to scientific studies, however, the brain cells begin dying within a very rapid time interval – within 5 minutes – further causing major bodily functions and organs to fail within 10 minutes. 

And considering how the average emergency response time is 7-14 minutes, the need for a fast reaction is crucial. This means that the transport to the hospital can take up to half an hour or more. The fastest medical intervention that can be performed with no equipment is CPR. 

CPR requires a persistent rhythm of chest compressions with both hands in the central chest area (not directly on the heart) to compress the muscles enough to restart the heart and help it pump blood once again. Ideally, thinking of a fast-paced song or having someone from the crowd play some fast songs (100-120 bpm) can be really helpful in maintaining a consistent rhythm. 

Proper CPR Assistance for Agonal Breathing Victims

As a bystander you can always be prepared if you have passed a CPR course and have your certification. When you are trying to help a person with agonal breathing, consider only giving hands-only CPR without mouth-to-mouth resuscitation. These are the basic steps to take when resuscitating an average adult (techniques for children and infants differ):

  1. Call 911

Regardless if you’re medical personnel or just a bystander, calling 911 on such occasions should be the first thing on your to-do list. If there are more people around you, have them call for assistance while you perform the life-rescuing technique. 

  1. Count the Breaths

As we mentioned, the lower-than-average 12 breaths per minute is one of the most common symptoms of agonal breathing, especially if the victim has already lost consciousness. If you have CPR training, you can try giving mouth-to-mouth resuscitation (rescue breathing) and counting the rescue breaths.

  1. Look for an AED

If you’re located in a highly-trafficked area, like streets surrounded by museums, airports or shopping malls, there’s a high probability of finding an automated external defibrillator (AED). Have someone from the crowd look for one while you perform CPR on the victim. They are usually left in visible locations, like hanging on the wall. 

These medical devices can be of great assistance in determining the heart rhythm of the victim. When necessary, an AED will also provide an electrical shock to the heart to restore its regular heartbeat.

Laypeople can use AEDs if they have at least a basic level of training in one.

  1. Don’t Stop Giving CPR

Agonal breathing can last for a very long time, but delayed response time can lead to brain damage. So, once you start giving CPR, don’t stop until emergency services arrive. If you get exhausted while administering CPR, you can ask for help from a bystander or even perform the technique using two people. As you may have learned in a CPR class

Either way, interrupting CPR can lead to more damage, so providing consistent chest compression is vital.

Wrapping Up What We Learned About CPR and If You Should Perform On A Agonal Breathing Victim

Let’s take a look at what we learned in this blog about CPR and performing it on a agonal breathing victim. A study conducted on a national level by the Cleveland Clinic has confirmed that only about 54% of Americans can perform CPR – a technique that increases the chances of survival in many scenarios.

At the same time, only around 11% – or one in ten people- were aware of the proper tempo of this technique, which is around 100-120 beats per minute and is one of the most crucial points when assisting with CPR.

So, can you perform CPR when someone is experiencing agonal breathing? The answer is yes! Since every second can be of life-saving meaning for a person that suffers a sudden cardiac arrest and agonal breathing, getting certified in CPR can truly save a life.