What is Agonal Breathing?

A person is said to have agonal breathing when he/she has difficulty breathing or produces a gasping sound. Such breathing is usually an indication that someone is suffering from a severe medical condition like sudden cardiac arrest (SCA) or stroke.

Gasping respiration isn’t proper breathing; instead, it’s a result of the brainstem reflex. It occurs when the heart fails to aid the circulation of oxygenated blood. Other times, it happens when the lungs stop supplying enough oxygenated blood.

Anyone who experiences gasping respiration should seek immediate medical intervention, whether or not it’s due to a medical emergency.

What are the Causes of Agonal Breathing?

Gasping respiration can occur due to several reasons. However, strokes and SCA are the leading causes of agonal breathing

SCA or sudden cardiac arrest is very different from a heart attack. It is caused by an electrical issue in the pacemaker, while a heart attack starts when blood vessels narrow, hindering blood flow.

When you suffer SCA, your heartbeat becomes irregular due to increased or decreased electrical impulses; this condition is called arrhythmia.

During this time, blood can continue to flow through your body organs and brain but at an irregular rate. You will then experience gasping respiration because of low and inadequate oxygen supply in the vital body organs.

Medics believe that the gasps should end after several minutes if the chief cause is cardiac arrest. An AHA study shows that you have a higher possibility of developing SCA after suffering a heart attack.

Cerebral ischemia is another common cause of agonal respiration. This condition arises when there’s a minimal blood flow to the victim’s head due to a ministroke or hemorrhagic stroke.

Ministrokes are usually a result of the blockage of blood flow within one or more of the brain’s blood vessels. Hemorrhagic stroke typically arises when one of the brain’s blood vessel starts to bleed.

All these conditions can be fatal to the brain’s functioning and can lead to a severe health problem known as cerebral hypoxia (low oxygen supply to the brain). If you suffer from this condition and don’t get prompt medical help, it can end up damaging your brain and its functions permanently.

Drug overdoses can also lead to agonal breathing, whereby the vital organs of the body start shutting down.

Anoxia can be another gasping respiration cause. It occurs due to a total deprivation of oxygen in the body. This condition is usually associated with drowning, strangulation, a severe asthma attack, or a halt in blood supply.

Conditions Similar to Agonal Breathing and Its Main Symptoms

Most people usually confuse agonal respiration with the death rattle and labored breathing. Death rattle refers to the gurgling sound people make when near death.

Labored breathing arises when very minimal oxygen reaches vital organs such as the brain because of various conditions such as lung infections, pulmonary embolism, or lung cancer.

On the other hand, agonal breathing occurs when the heart stops beating; thus, the body lacks oxygen, and a person starts gasping for oxygen-rich air. To help you better understand gasping breathing, here are some of its manifestations.

Image Alt tag: Agonal breathing

On some occasions, gasping respiration may sound like snorting, moaning, or difficulty in breathing. Another sign of gasping respiration is the twitching of muscles that victims make as they struggle to get enough air.

The symptoms and duration of the gasping will take usually depend on its primary cause. This problem can also make the patient unconscious.

Other stroke symptoms include; facial drooping, poor coordination, sudden headaches, incoherent communication, difficulty maintaining consciousness, and one side of the victim’s body becoming weak.

Responding to an Agonal Breathing Emergency

When someone gasps for air, it’s an indication that something isn’t right. Therefore, anyone suffering this condition should get immediate medical assistance regardless of a known or unknown cause.

You should immediately call any emergency medical transport service around your area and ensure you explain to them the victim’s breathing pattern and behavior plus any other symptom they are showing at the time.

If they ask you whether the patient is still breathing, you must be specific and explain to them that the victim isn’t breathing normally. You can how his/her breaths are by using terms such as gasping, moaning, or labored.

After that, you should ask the dispatcher what you’re supposed to do and if appropriate, perform CPR on the victim. This is easier if you have undergone training and acquired CPR certification.

In case you’re confident that the victim is undergoing a cardiac arrest and you know the CPR process, you should immediately start administering continuous chest compressions until help arrives.

If you don’t know the process, ask the over-the-phone operator how to perform the compressions correctly.

There are other circumstances where an AED can help resuscitate SCA patients. If you can’t access one at the moment, your best alternative is uninterrupted chest compressions.

When both the resuscitation and AED fails to restore the patient’s heartbeat, the paramedics/ doctors will use a mechanical ventilator to restore the heart rhythm.

The Right Way of Treat Agonal Respiration

Treating agonal respiration can be simple or complicated, depending on the cause. Nonetheless, the victims should get assistance ASAP regardless of the cause.

First, it’s crucial to restore the heart rhythm to a normal through CPR and include an AED (if the heart isn’t beating).

You know the victim is starting to when he/she starts to;

  1. Breath normally.
  2. Move in a slightly disoriented or regular manner.
  3. Wake up.
  4. Sound or look responsive.
  5. Respond when touched
  6. Express painful feelings other than the gasping respiration moaning.

In more complicated situations, treating agonal respiration may require the victim can need a mechanical ventilation machine to aid in oxygen flow in body organs and letting air into the lungs. The patient will also require additional cardiopulmonary medication to stabilize the body’s blood pressure and breathing.

With the increased ailments that can cause agonal respiration, such as the deadly COVID-19 virus, it’s crucial for all parents, teachers, and daycare professionals to consider knowing more about agonal respiration and its remedy even when they don’t understand what causes it.

The Dangers of Ignoring Agonal Breathing

FDA.gov reports show that an individual’s survival odds drastically reduce by 10% every minute their heart doesn’t pump normally. When someone experiences agonal respiration, they can be alive for about five to ten minutes.

Emergency respondents can revive such a victim after this duration, but it’s risky and closely associated with long term damage. A MedlinePlus study indicates that when brain cells don’t get oxygen for five minutes, they start dying, which within the next ten minutes or more, permanent severe brain or organ damage can happen.

From Reuter reports, ambulances usually take approximately 14 minutes to reach a scene. About 10% of the US citizens wait for about half an hour for an ambulance to arrive at their locations, meaning early resuscitation can make a significant difference in saving a life.

Therefore, just calling for medical assistance and waiting for them will lower the victim’s survival probability. You should try to restore his/her heartbeat by performing CPR or using an automated defibrillator if available.

Most AEDs have voice prompts and guidelines for users to quickly and efficiently use them. The defibrillator will monitor the victim’s heartbeat and instruct whether or not the patient needs the device.

An FDA report shows that most people typically don’t know that AEDs are in most public institutions, malls, and airports, and anyone is free to use them when an emergency arises. In case the incident happens in one of these places, be sure to check for them.

They usually are placed in easily accessible areas such as on exits, walls, restrooms, nurse’s stations, and break rooms with apparent easy-to-see signs and conspicuous colors.

How CPR Certification Prepares you for an Emergency

Throughout your lifetime, you will likely come across a health emergency that requires you to perform CPR. With CPR Certification, you get the skills and confidence needed to conduct any form of resuscitation.

Besides the skills, having CPR Certification is an added advantage to your resume. Numerous online courses and institutions are offering CPR education to all groups of people.

Upon completion of this CPR course, you’ll be able to handle various CPR related medical conditions, including agonal breathing.


Agonal respiration isn’t a condition anyone should ignore or take lightly. It requires urgent attention and medical assistance, or else it can have severe implications for the victim.

When someone is in this state, it’s best to ensure medical assistance is on the way, try to make the victim respond to you, and begin administering CPR to help maintain life until the EMT professionals arrive.

Finally, consider seeking CPR Certification to sharpen you lifesaving skills.