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I've taken several CPR classes, and I used to believe that anyone needing CPR would be totally unresponsive and not breathing at all. But in reality, one symptom of cardiac arrest is agonal breathing, which can look like a person is struggling to breathe or snoring.
Here's an actor showing what agonal breathing looks like. If you see someone collapse and assume they’re fine because they’re breathing, be aware that this individual still requires immediate CPR and a call to 911.
CPR courses emphasize the importance of recognizing when someone isn’t breathing properly. Agonal breathing isn’t normal; it’s a reflex that happens when the brain isn’t receiving enough oxygen.
In a way, it's a positive sign, as it indicates the person's brainstem is still functioning. Individuals experiencing agonal breathing during a cardiac arrest are generally more likely to survive than those who do not, although the harsh reality is that survival odds remain slim regardless.
What should you do if you witness someone collapse and gasp?
If someone collapses before you and exhibits gasping, groaning, or snoring sounds, it’s crucial to act quickly. Skip checking for a pulse, as it only wastes time. If the person is alive, they will react by pushing you away or asking you to stop. If you’ve received CPR training recently, follow your training. For others, the typical advice is to:
Start hands-only CPR with quick chest compressions, matching the tempo of Stayin’ Alive
Have someone dial 911
If possible, ask someone to find an AED (automated external defibrillator), commonly located in public areas
According to Arizona’s Sarver Heart Center, agonal breathing may actually be more effective than mouth-to-mouth resuscitation for delivering air into the chest. Therefore, there’s no need to perform mouth-to-mouth. Hands-only CPR is now the recommended approach.
