Should You Perform CPR on Some Who Is Gasping or Unconscious?

woman doing CPR on a man
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When someone is unconscious/unresponsive and not breathing, they are in clear need of CPR. The same can be said if they are instead taking gasping, irregular breaths. Known as agonal breathing, this is common after cardiac arrest, but is definitely not considered normal. Even though it may look like the person is getting some air, the victim’s gasping breaths indicate that CPR should be started immediately. 

Gasping and Survival

When a patient gasps after collapsing from cardiac arrest (when the heart stops working correctly and can't get blood to the lungs, brain, and other organs), it can look like a reflex of the chest and neck muscles trying to get more oxygen. Those gasps can sound like snoring, snorting, or labored breathing, but are different from normal breaths and can happen every few seconds.

Agonal breathing may sound and look alarming, but it can be a good sign for a victim’s chance for survival. It can improve oxygenation and circulation while CPR is being performed.

A study of CPR patients in Arizona found that patients who were reported to have gasped after having an out-of-hospital cardiac arrest had better survival rates, especially when given CPR (39% compared to 9% in those who did not gasp). Another study found that gasping during CPR was associated with increased survival rates after one year with favorable neurological outcomes.

Both studies emphasized the importance of recognizing gasping as a sign of cardiac arrest and continuing CPR when those gasps are detected.

According to the American Heart Association, every minute that CPR is delayed, a patient's chance of survival decreases 10%. 

CPR When Someone Has Gasping Breaths

When agonal breathing happens after cardiac arrest, it doesn't happen for long, so it's important to act quickly and start CPR. Gasping is more common after a person collapses and diminishes quickly as each minute goes by.

For an unconscious patient who isn't breathing or is gasping for air every few seconds, call 911 and start CPR chest compressions.

Hands-only CPR on an unconscious patient who is gasping has a good chance of being effective. According to the American Heart Association, you should:

  • Do compressions in the center of the chest, pressing down about two inches with your whole body weight, quickly and forcefully. (Don't be afraid of hurting the patient.)
  • Make sure your shoulders are directly over your hands and keep your arms straight as you do the compressions.
  • Maintain a rate of 100 to 120 compressions per minute, about the same tempo as the song "Stayin' Alive" by the Bee Gees.

If you're unsure of what to do, the 911 dispatcher should be able to help. Importantly, don't stop chest compressions unless someone can take over for you or until emergency help arrives.

Starting CPR on a gasping patient won’t hurt them. It can only help them—and may just save their life.

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Article Sources

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  1. Debaty G, Labarere J, Frascone RJ, et al. Long-Term Prognostic Value of Gasping During Out-of-Hospital Cardiac Arrest. J Am Coll Cardiol. 2017;70(12):1467-1476. doi:10.1016/j.jacc.2017.07.782

  2. Bobrow BJ, Zuercher M, Ewy GA, et al. Gasping during cardiac arrest in humans is frequent and associated with improved survival. Circulation. 2008;118(24):2550-4. doi:10.1161/CIRCULATIONAHA.108.799940

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