The Importance of Recognizing Agonal Breathing in Cardiac Arrest Situations

Quick Thinking and Proper CPR Techniques Can Make a Difference

It was a typical day for one ER professional when they stumbled upon an unconscious elderly man on the street. Shockingly, the man had urinated himself, indicating that something was seriously wrong. Acting swiftly, the ER professional noticed that the man was in the recovery position, a common posture for someone who is unconscious.

Without wasting any time, the ER professional checked the man's airways and found them to be clear. However, they noticed that the man was making a snoring sound, which led them to believe that he was breathing. Little did they know that this snoring sound was actually a sign of a grave medical emergency.

Thankfully, the paramedics arrived on the scene and immediately recognized that the man had gone into cardiac arrest. They wasted no time and began performing CPR on the man's chest. However, to the surprise of the ER professional, the paramedics did not perform breaths, raising questions about the correct protocol in such situations.

Curiosity got the better of the ER professional, and they approached one of the paramedics to understand what had gone wrong. The paramedic explained that some breathing patterns, such as snoring sounds, can actually be a type of reflex breathing called agonal breathing. This reflex breathing can occur once the heart has stopped, giving a false impression that the person is still breathing. To truly determine if someone is breathing, feeling for a pulse or using an EKG is crucial.

Another ER professional reassured their colleague that they did not do anything wrong and that recognizing agonal breathing without medical training is difficult. In fact, even highly trained professionals can sometimes struggle to identify it. The ER professional, who happened to be an ICU physician, added that survival rates for cardiac arrest outside the hospital are generally very low, even with the fastest response from highly trained professionals. CPR is designed to maintain a person's condition until EMS arrives, but it cannot bring a dead person back to life.

Guilt and self-blame can often linger in the minds of those who find themselves in such situations. The ER professional was advised to take it easy on themselves and seek support from others. The reality is that survival rates for cardiac arrest are low, and even the most skilled professionals face challenges.

Another ER professional chimed in, commending the ER professional for their quick thinking and willingness to help someone in distress. They emphasized that CPR is only effective in a small number of people, and an AED (automated external defibrillator) may have been the only device that could have made a difference in this particular situation.

The ER professional was thanked for being a good Samaritan and stopping to help someone in need. Another ER professional shared insights from their experience working for an EMS company, stating that hands-only CPR is better than doing nothing at all. They explained that air is not as vital during CPR, as the compressions are strong enough to inflate and deflate the lungs.

Interestingly, research from medics in Asia revealed that performing CPR with the patient in an up***ht position can yield better survival rates. This discovery was made when medics had to prop up patients in elevators during CPR, resulting in higher rates of return of spontaneous circulation (ROSC).

Recognizing agonal breathing in cardiac arrest situations is crucial for providing appropriate medical care. While survival rates for cardiac arrest outside the hospital are generally low, quick thinking and proper CPR techniques can make a difference. It's important to remember that guilt and self-blame should be avoided, as the outcome of such emergencies is often beyond anyone's control. By staying informed and seeking support, ER professionals can continue to be the compassionate and dedicated individuals they are.