Agonal Breathing: Why Gasping Is Not Breathing

Agonal breathing is the irregular gasping that can happen when someone’s heart has stopped. It can look like breathing. It is not. If a person is unresponsive and not breathing normally, start CPR.

What agonal breathing looks and sounds like

People describe it as gasping, snorting or occasional deep, laboured breaths with long pauses in between. It is slow and irregular, and it does not move air the way normal breathing does.

Why it matters

Bystanders who see the chest move may decide the person is breathing and wait. That delay costs time when every minute without compressions counts.

The Australian and New Zealand Committee on Resuscitation (ANZCOR) is direct about this in its CPR guideline:

Rescuers must start CPR if the person is unresponsive and not breathing normally. Even if the person takes occasional gasps, rescuers should start CPR.

What to do

Follow the DRSABCD sequence you were taught. In short:

1. Danger. Make sure the area is safe for you and others.
2. Response. Check if the person responds to voice and touch.
3. Send for help. Call your local emergency number (000 in Australia) or get someone to call.
4. Airway. Open the airway.
5. Breathing. Check for normal breathing. Gasping is not normal breathing.
6. CPR. If unresponsive and not breathing normally, start CPR: 30 compressions followed by two breaths.
7. Defibrillation. Attach an AED as soon as one is available and follow its prompts.

This is a general summary for education. Do a recognised first aid course and follow current ANZCOR guidance or your local equivalent.

Practising the decision

The hard part is not the compressions. It is deciding to start when the person seems to be breathing. That is a judgement call best practised before it is real.

In the Firsthand XR workplace collapse and electrical rescue scenarios, learners check for danger, response and breathing before deciding to start CPR and use the AED. Each step is timed in the debrief, so a delayed start is visible. See the first aid and CPR page, or students can join the waitlist for a free CPR and AED basics scenario.