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Is it OK to do CPR on an unconscious person who is barely breathing?

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Updated April 16, 2014

Question: Is it OK to do CPR on an unconscious person who is barely breathing?

A study of CPR patients in Arizona found that gasping breaths (often called agonal respirations) are common soon after cardiac arrest. Many paramedics have arrived to find their unconscious "breathing" patients actually had agonal respirations. Bystanders -- worried about hurting the victim -- hesitate to start pushing on the chest of a person gasping for air. So, is it OK to do CPR on an unconscious person who is gasping for air?

Answer: Yes.

When the heart stops pumping hard enough to get blood all the way from the lungs to the brain and back, we call it cardiac arrest. Trained rescuers recognize cardiac arrest by feeling the victim's carotid pulse (located on the side of the neck). If there's enough blood flowing by on the way to the brain, there will be a pulse. If not, there won't. Whether the heart is going through the motions of beating, quivering uncontrollably, racing extremely fast or lying perfectly still doesn't matter.

All that matters is whether there is enough blood making the round trip between the brain and lungs. If not, the victim needs CPR. Some of those victims will be gasping for air, but your friendly neighborhood paramedic won't care. She'll still pump on the victim's chest to help get blood flowing again.

Untrained rescuers use something closer to intuition to recognize cardiac arrest. Simply put, look at the victim. Does he look dead or dying?

If the guy looks as if he's not breathing -- which by default means he's not awake and talking because talking requires breathing -- then call 911 and start pushing on his chest.

There's a good chance the victim will be gasping his or her last breaths. In my experience, that gasping resembles the last furtive spasms of a fish out of water. It doesn't look like breathing as much as a reflex of the chest and neck muscles trying to grab a few more molecules of ever important oxygen. CPR on this patient, particularly hands-only CPR, has a good chance of being effective.

If you're looking at a person you can't wake up and aren't sure if he or she is breathing, he or she probably isn't. If the victim is taking such shallow breaths you can't see the chest rising and falling, it's not enough. If the victim is gasping every few seconds for air, it's not enough. Either way, call 911 and push on the chest.

CPR is changing. There's been a lot of research done recently trying to determine what kind of CPR is better and who should perform it. In all of this research there has been a finding that most nonscientists would say, "Duh!" to: doing something is better than doing nothing.

Good advice, whether they're gasping for air or not.

Source:

Bobrow, B.J., et al. "Gasping during cardiac arrest in humans is frequent and associated with improved survival." Circulation. 2008 Dec 9

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