CPR 101: What is Agonal Breathing? How to Maximize Survival Rate During Cardiac Arrest.

This golden hour CPR not witnessed proper chest compressions Agonal breathing 911 emergency

In our city the emergency runs out numbers fire calls. When a call comes in for a cardiac arrest I can help but think on my way to the callers address will I be able to help this person stay alive. When it comes to survival rates for people who are in cardiac arrest it is hard to tell who will survive and who will not no matter how good I do my job.

The survival rate is much better if someone witnessed the cardiac arrest and calls 911 immediately and the person has a shock-able rhythm.

Most patients have a good survival rate if resuscitated within five minutes. The longer it takes for a person to receive CPR and be resuscitated the lower that individual’s rate of survival will be.

The impact on someone’s survival depends on these factors early recognition of cardiac arrest, early activation of the EMS system ( 911), early instructions of continuous chest compressions, and mouth to mouth ventilation.

Early recognition of cardiac arrest is very important but sometimes delayed because of what we call agonal breathing. This happens in over half of patients for a few minutes after having a cardiac arrest.

Agonal breathing is described as the following: gurgling, labored breathing, snoring, noisy or heavy breathing, moaning, or gasping. 

When a person witnesses someone collapse on the floor and the person is still gasping or making other labored breathing sounds, this witness has just failed to recognize a cardiac arrest.

Then when this witness finally decides to call 911 and the operator asks the witness if the person is breathing. The witness will probably tell the operator yes because the patient is still making breath like sounds.

A witness or bystander who has called 911 can help a patient survival rate by listening to the emergency operator give instructions on how to give compressions and ventilation to the patient.

In Alabama they are teaching us to give two initial breaths and then 100 uninterrupted chest compressions before we give another two breaths. In teaching us this procedure our instructor would put on the song another one bites the dust. This would teach us the rhythm we would need to do chest compressions.Continued and proper chest compressions will help keep the blood flowing to the brain and give this patient a better survival rate.

We are also being taught if the cardiac arrest was not witnessed that we should give the patient 200 chest compressions before shocking the patient and 200 after shocking the patient if the patient hasn’t responded.

When I came on the fire department 23 years ago and I was taught CPR. The instructor told us about the golden hour of patient survival from a heart attack. This golden hour is still vital to patient survival rate today.


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Teresa Farmer
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carol roach
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Posted on Sep 11, 2009