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When is gasping NOT breathing?

If you ever have to call 000 for a medical emergency one of the most important questions you will be asked is, “Is the person breathing?”

How you can answer that question and whether you are right or not, can literally be a matter of life and death.

As one of our trainers discovered recently, the most common confusion stems from something called “Agonal breathing” which often happens to people after a cardiac arrest. This gasping for air can lead you to believe a person is breathing when they are not.

What happens is that when your body suffers a Cardiac Arrest, the heart has an electrical fault which can throw its regular rhythm out. As the heart and lungs work together to keep oxygenated blood flowing through your body, when your heart stops doing its regular job, your lungs get thrown out of their rhythm too.

This type of gasping is often compared to a fish being out of water. The person will suddenly let out a huge gasp as the body desperately tries to suck in some oxygen by expanding the lungs and chest, but then the lungs will collapse quickly again and there will be no more breath for a while. Then after a short period of time, the person will gasp again and so on. Gradually this keeps subsiding even though it can go on for up to 8 minutes.

The problem is, if you are unfamiliar with this and are on the phone to the ambulance when the person lets out a gasp and they ask “are they breathing?”, you can be tempted to say “Yes!”.

But the question is actually “are they breathing NORMALLY”. If they are not breathing normally, you must immediately administer CPR. If you don’t and think “well they seem to be breathing I’ll wait for the ambulance”, their chances of dying before it arrives increase dramatically.

So, if you find yourself confronted with someone who has collapsed and you don’t know why, and the person is like a fish out of water, gasping for air intermittently, then you can be pretty certain they not actually breathing normally.

The first solution is to apply CPR fast. This means you take over the function of breathing for them, by compressing the lungs and pumping the heart to keep oxygenated blood flowing through the body. Now they may keep gasping as you apply CPR but their chance of survival will be higher

than if you didn’t do it. Ultimately if you can get a defibrillator on them and reset their heart, their chances of survival will increase even more than if you can only do CPR.


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