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In the event of sudden cardiac arrest, victims may exhibit heavy breathing for a few seconds to a few minutes after their heart has stopped. It is important to note that this type of breathing is not normal and requires urgent action. Continue reading to discover what action to take in response to this agonal breathing.
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Agonal breathing is a sign of severe medical distress, often occurring during cardiac arrest. It is characterized by slow, shallow breaths with pauses in between, and is frequently accompanied by gurgling or snoring sounds. Although agonal breathing may sound like gasping, it is not effective breathing and does not provide adequate oxygenation to the body. If agonal breathing is detected, CPR should be initiated immediately. Agonal breathing does not indicate normal respiratory function and should not delay the administration of chest compressions. Prompt and high-quality CPR can improve the chances of survival and prevent further complications from oxygen deprivation.
The medical significance of agonal breathing is that it is often a symptom of a life-threatening medical emergency such as heart attack or respiratory failure. Agonal breathing can be a sign that the body is not receiving enough oxygen and is in need of immediate medical attention. Therefore, it is important to recognize the signs and symptoms associated with agonal breathing so that appropriate steps can be taken to provide the necessary medical treatment.
Agonal breathing is often associated with cardiac failure, which occurs when the heart’s electrical system malfunctions and the heart stops beating. When this happens, agonal breathing can occur due to oxygen deprivation in the body. Agonal breathing is one of the first signs that a person is experiencing sudden cardiac event, and it typically appears within seconds to minutes after the onset of cardiac arrest. Therefore, recognizing the signs and symptoms of agonal breathing can be vital to providing timely medical treatment.
The signs and symptoms of agonal breathing can vary depending on the underlying cause. However, common signs and symptoms include shallow, rapid breaths that are often labored or spasmodic, with pauses between breaths.
A person experiencing agonal respiration typically breathes slowly, averaging around 10-12 breaths per minute, in contrast to the 12-25 breaths per minute typical of a person not experiencing respiratory distress. The disparity will likely be noticeable unless the person is a slow, controlled breather like one who practices yoga. Additionally, involuntary muscle spasms may be observed, which could be mistaken for a heartbeat. This is probably a reflexive response.
Agonal breathing can be distinguished from other types of breathing by its irregular and labored pattern. Agonal breathing is characterized by gasping or spasmodic breaths, which are shallow and rapid, with pauses between breaths. In contrast, normal breathing is regular and effortless, with each breath being deep and full. Additionally, agonal breathing often occurs during an acute medical emergency, such as cardiorespiratory failure, while other types of breathing do not.
The difference between agonal breathing and gasping is that agonal breathing usually occurs during a life-threatening medical emergency while gasping is typically a reflexive response to pain or distress. Agonal breathing often involves irregular chest contractions and pauses in respiration, whereas gasping is more of a shallow, rapid inhalation of air. Additionally, agonal breathing can last from seconds to minutes, while gasping usually lasts only a few seconds.
The death rattle is a sound created when a person is close to death as air passes through their throat and chest. It is usually a gurgling noise that occurs due to a lack of muscle control in the throat. Agonal respiration is a type of unusual and labored breathing seen in a dying person. It usually has a pattern of a few normal breaths followed by a series of irregular breaths, and it is often considered to be a sign that death is imminent.
Individuals with Chronic Obstructive Pulmonary Disease (COPD) may encounter shortness of breath, coughing, and wheezing when engaging in a physical activity requiring exertion.
In contrast to agonal breathing, COPD develops gradually, often due to long-term smoking or exposure to harmful substances. During a severe COPD attack, individuals usually remain alert and capable of normal movement. This observation also holds true for asthma attacks.
Pulmonary Embolism (PE) denotes an abrupt obstruction of the pulmonary artery, which supplies blood to the lungs. Many individuals afflicted with PE do not display premonitory symptoms leading to developing a significant blood clot. However, once symptoms manifest, they typically entail chest discomfort, difficulty breathing, and the expectoration of blood through coughing.
Gasping is a sudden, involuntary intake of breath, often a reflex caused by lack of oxygen. It may occur during a medical emergency like cardiac arrest, where the brainstem triggers erratic, ineffective breathing attempts. Gasping is not normal breathing and should prompt immediate action such as CPR.
Labored breathing refers to breathing that requires more effort than usual. It may include signs like nasal flaring, use of accessory muscles (shoulders, chest), grunting, or visible distress. It can be caused by conditions like asthma, pneumonia, heart failure, or severe anxiety.
Gurgly breathing is a noisy breathing pattern where air moves through accumulated fluid or mucus in the throat or lungs. It often occurs at the end of life (known as the "death rattle") or during agonal breathing. It indicates poor airway clearance and should be monitored closely.
Shallow breathing before death is characterized by low-volume, weak breaths. It is part of the body’s natural shutting down process and may accompany other signs like cool extremities or decreased responsiveness. Shallow breathing differs from agonal breathing, which is more irregular and gasping in nature.
Nocturnal agonal respiration refers to agonal gasping that occurs during sleep. This may indicate sudden cardiac arrest during the night, often linked to heart rhythm abnormalities or severe sleep apnea. It is a medical emergency and requires immediate intervention, including CPR.
Guppy breathing (sometimes used colloquially) refers to small, open-mouth gasps that resemble a fish out of water. It is often considered a lay term for agonal breathing, but not all guppy breathing is agonal. Agonal breathing typically involves deeper, more irregular gasps and may include gurgling or snoring sounds. Both suggest severe oxygen deprivation and require emergency response.
Ragged breathing is not a medical term but is often used to describe erratic, uneven, or noisy breathing patterns. It may occur during respiratory distress or at the end of life and is often mistaken for agonal breathing. If someone is experiencing ragged or irregular breathing along with unresponsiveness, initiate emergency care immediately.
Agonal breathing is characterized by labored noisy breathing with long pauses and gasps. It may sound like gasping breaths, but it can also sound like snorting and labored breathing. It may even seem as though the person is moaning. The abnormal breathing may last for a few breaths or extend to several hours. The cause of agonal respiration will affect the duration and whether there are other symptoms.
Agonal breathing typically lasts for a short period of time, usually no longer than several minutes. The duration of agonal breathing depends on the underlying cause and any treatments that are administered. In cases of heart failure, agonal breathing can last up to 10 minutes if CPR is not initiated. If CPR is started immediately, the duration of agonal breathing may be reduced significantly. In cases of respiratory failure, agonal breathing may last for several minutes or longer, depending on the severity of the condition and any treatments that are given.
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Agonal breathing can be caused by any interruption of the brain's blood supply, depriving it of the oxygen required for its functioning. Possible scenarios which may lead to agonal breathing include:
Agonal breathing affects the brain and body by depriving them of oxygen. This can lead to confusion, dizziness, changes in consciousness or coma, and even death if not treated quickly. Additionally, agonal breathing can cause significant damage to the heart, lungs, and other organs due to a lack of oxygen. Agonal breathing can also cause an increase in blood pressure, which may lead to further complications. Therefore, it is important to seek immediate medical attention if someone is exhibiting signs of agonal breathing.
The autonomic nervous system plays an important role in agonal breathing. This system regulates the body’s involuntary functions, such as heart rate, respiration, and blood pressure. During a medical emergency such as cardiac arrest or respiratory failure, the autonomic nervous system can become overstimulated which can lead to agonal breathing. Agonal breathing is caused by a series of involuntary muscle contractions in the chest, which are stimulated by the autonomic nervous system.
Certain drugs and medications can increase the risk of agonal breathing due to their impact on the autonomic nervous system. Other risk factors include advanced age, smoking, obesity, and underlying health conditions such as hypertension or diabetes. It is important to be aware of these risk factors so that appropriate medical treatment can be sought if agonal breathing is suspected.
Yes, agonal breathing can occur in individuals who are not dying. Agonal breathing may be caused by a number of factors other than cardiac failure, such as respiratory failure due to asthma or COPD, extreme physical exertion, drug overdose, or neurological conditions. In these cases, the person may initially experience agonal breathing, but with timely medical intervention and treatment, the individual can often recover.
The treatment for agonal breathing depends on the underlying cause. In cases of heart failure, cardiopulmonary resuscitation (CPR) and defibrillation may be needed to restore a normal heartbeat. For respiratory failure, supplemental oxygen and other treatments may be used to support breathing. Medications such as sedatives or muscle relaxants may sometimes be given to help control breathing.
Agonal breathing is a sign of cardiac arrest. Immediate action is critical. Here's a Bystander Action Plan:
CPR (Cardiopulmonary Resuscitation) can be used to help with agonal breathing by restoring circulation and oxygenation to the body. It is important to begin CPR as soon as possible when agonal breathing is present, as it is often a sign of cardiorespiratory failure. During CPR, chest compressions are used to maintain circulation and help restore oxygen flow to the body. This can help to reduce the severity of agonal breathing and may even restore normal breathing.
You can respond to cases of agonal breaths by providing CPR chest compressions at a rate of 100-120 beats per minute. If available, utilize an automated external defibrillator (AED) to restart the heart of someone in sudden cardiac arrest. Research indicates that cardiac arrest victims exhibiting agonal breathing are likely to benefit most from rapid CPR and defibrillation, increasing their likelihood of survival.
In the event of someone experiencing agonal respiration, it is important to take prompt action. Below are the steps to follow:
Remember to keep the person awake if they wake up, and seek medical attention as soon as possible.
In addition to CPR, emergency medical services may administer drugs to treat the underlying cause and provide ventilation or intubation if oxygen isn't entering the body properly. These medical treatments are essential for addressing a dangerous irregular heart rhythm called ventricular fibrillation.
Agonal breaths may look like weak attempts to breathe. This can confuse bystanders into thinking the person is alive, leading to delays in life-saving actions. It's important to recognize agonal breathing as ineffective for sustaining life.
The characteristic gasps are caused by partial airway obstructions, involuntary diaphragm contractions, and lack of coordination between respiratory muscles and the brain.
Yes, agonal breathing also occurs in:
Survivors may experience neurological impairments due to oxygen deprivation, potential complications from the underlying cause, such as cardiac issues, and rehabilitation needs for physical and cognitive recovery.
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