What is Agonal Breathing?

Agonal breathing is an irregular pattern of breathing, characterized by gasping or labored breaths, which may sound like snoring or gurgling. Contrary to what some may believe, this is not a sign of recovery or adequate oxygen flow.

It’s essentially a reflex caused by the brain trying to restore normal breathing patterns in the absence of oxygen. When we see this type of breathing, it indicates that the brain is experiencing a significant lack of oxygen.

Signs of agonal breathing

Agonal breathing is a distinct and specific type of abnormal breathing pattern often associated with life-threatening medical emergencies, especially cardiac arrest.

Recognizing agonal breathing is crucial because it can sometimes be mistaken for effective breathing, which may delay the initiation of life-saving interventions like CPR.

Here are the signs of agonal breathing:

  1. Gasping Sounds: One of the most defining characteristics of agonal breathing is a sudden gasp or snorting sound. This is not like the typical intake of breath when someone is startled, but rather a reflexive attempt by the body to draw in air.
  2. Infrequency: Agonal respirations are not consistent like normal breathing. They happen intermittently. A person might gasp, and then there might be a long pause before another gasp.
  3. Shallow Breaths: The breaths taken during agonal breathing are typically shallow and may not provide significant oxygen to the lungs.
  4. Gurgling or Snoring: Due to the presence of secretions or the tongue falling back into the throat, agonal breathing might be accompanied by a gurgling or snoring sound.
  5. Lack of Responsiveness: Individuals exhibiting agonal breathing are usually unresponsive. They don’t react to stimuli, don’t answer when spoken to, and don’t follow commands.
  6. Absence of Other Signs of Life: Along with being unresponsive, individuals with agonal breathing may lack a detectable pulse or any other signs of life.

It’s important to note that agonal breathing is a sign of a severe medical emergency. If someone is displaying these signs, especially in combination with unresponsiveness, it’s critical to call emergency services immediately and begin CPR if trained to do so.

Agonal Breathing CPR: To Do or Not to Do?

If someone demonstrates rapid agonal breathing, it is an important question whether to apply CPR.The short answer is yes. Accordingly, American Heart Association and other EMS worldwide recommend administering CPR on an individual who is unresponsive and exhibiting abnormal breathing like agonal breathing.

Image alt text: agonal breathing CPR.

Author credit: By Nefronus – Own work, CC0, https://commons.wikimedia.org/w/index.php?curid=81515886

Sometimes, agonal breathing is confused with normal breathing but one should separate these two. Know that agonal breathing is irregular, light, and may sound strained. When in doubt about whether breathing is normal or agonal, it is preferable to go ahead with administering CPR.

5 Commonly Asked Questions about Agonal Breathing CPR

  1. Is agonal breathing a sign of life?

No. Agonal breathing is a reflex and does not indicate adequate oxygen flow or recovery. It signals a desperate need for intervention.

  1. If someone is gasping for air, should I wait to see if they recover?

No. If someone is unresponsive and showing signs of agonal breathing, begin CPR immediately. Time is of the essence in such situations.

  1. Can agonal breathing occur after a heart attack?

Yes. Agonal breathing can occur after cardiac arrest when the brain lacks adequate oxygen.

  1. Will CPR harm someone if they’re only experiencing agonal breathing?

Initiating CPR when unsure is always better than withholding it. If someone doesn’t need CPR, they may respond to the initial compressions, which is a good sign to reevaluate.

  1. What’s the first step if I encounter someone with agonal breathing?

Ensure the person is in a safe environment, call emergency services, and start CPR if they are unresponsive.


The topic of “agonal breathing CPR” is vital for everyone to understand, regardless of their medical background. When faced with a situation where someone displays rapid agonal breathing, recognizing it and knowing the appropriate action to take can be the difference between life and death.

Agonal breathing is not a sign of life but a critical indication of distress. Starting CPR when someone is unresponsive and experiencing agonal breathing can potentially save their life. Remember, it’s always better to take action and start CPR rather than waiting and wondering. Every second counts, and your timely intervention could be the lifeline someone needs.

With knowledge comes power, and by understanding the nuances of “agonal breathing CPR”, you’re better equipped to face emergencies head-on. Here’s hoping that you’ll never need to use this knowledge, but if you do, may it guide you in making the best decisions.