Agonal Breathing

[southpaw7890]

This is a good example but agonal respirations can be a lot louder, more of an aggressive sucking.

[tingmarco1]

just known as a extreme bradycarina is a end with a asystole suffing.

[ryanbirch]

Can their eyes be open when this happens as well? Like a blank stare?

[foskco87]

Agonal breathing can be much more intense and distracting than this. I did an arrest a couple days ago and the man was breathing full loud breaths at a rate of 30/min. He still had a weak carotid but then arrested and continued to breath this way which made him appear to still be alive. We worked him for 40 minutes with ALS unsuccessfully and he was still breathing when we called it. I had never seen agonal breathing like that before.

[Bunomous]

id be laughing

[fwed1]

Never would have though they would be like this. I have only ever had them described to me, never seen them.

[princexiaoxing]

OMG!!!!!!!!!! WHY ISN'T THE CAMERA MAN DOING ANYTHING ABOUT IT?!?!?! The man seems to be in distress!!!

Haha ok I'm not really serious about ^pls do not take offence :)... just attended to a case of cardiac arrest, first time encountering agonal breathing. Vid's great and helpful! Though I would say the rate of agonal breathing would be lower, probably around 3-4/min. And take note, with the OPA in, it seemed as though he was having gag reflex. when in doubt, always check for the carotid puls

[sheilastanaland]

My husband died in Dec 2010, and he collapsed in the hall of our house while I was trying to hold him up. I had no idea what the shaking was, or that his breathing was not real breathing. I did call 911 immediately, but they never mentioned to check his pulse. If I'd only known that it looked like this, I could have given him CPR - I took it a long time ago, but never heard about this kind of reaction. Thanks for posting - this answered a lot of questions I had.

[Zeanu]

Hahah, yeah that's it right there. Funny how weak the human machine can be. Or is.

[longtail4711]

Excellent video, thanks so much for posting this!

[justawordaway]

Very nice. Thanks a lot

[elegantspirit928]

wow - excellent depiction.

[pabsw]

very good. thanks.

[XoMadelaine]

This was very helpful!

[americanmed]

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[zaxterry]

WHAT A STUPID ASS VIDEO!!! how dare you fake somthing like that. this is SICK SON!!!

[ForcaConcordia]

@zaxterry

There are people specialized in faking things like this just so that other people can learn from it. It can help people recognize this in a real live situation.

[midwife2thesoul]

This is a great video, not just for cardiac arrest but also the agonal breathing -- thank you for sharing - this may help a lot of people!!!

[fletchrx7]

There is an excellent video on YouTube of this happening for real!

It's a bunch of lifeguards on bondi beach doing a photoshoot when an asian student has a cardiac arrest in the water. He survives but you can clearly see his agonal breathing.

An excellent training aid for anyone doing courses

Hope this helps

[resolutionairy]

just did CPR on a middle-aged man this morning; it looked EXACTLY like this! Some bystanders were trying to tell me to stop CPR because they thought he was breathing, but fortunately I knew better (plus, he didn't have a pulse!). When the medics arrived, they hooked him up to an AED and it called for a shock, so there's no doubt that the CPR was necessary. He was breathing on his own when they loaded him up on the ambulance....

[jakubvondrak]

@resolutionairy I just saw video how this looks in reality and the difference was that the chest was not moving. He was not really breathing. Just opening mouth.

[Tformosus]

@jakubvondrak Cant claim to have seen Agonal breathing yet myself, but this was pointed out as good example of what it's like - note the odd gulping mouth/tongue movements / irregular breaths - do a search for "Bondi lifeguards bring a man back to life! "

[resolutionairy]

just did CPR on a middle-aged man this morning; it looked EXACTLY like this! Some bystanders were trying to tell me to stop CPR because they thought he was breathing, but fortunately I knew better (plus, he didn't have a pulse!). When the medics arrived, they hooked him up to an AED and it called for a shock, so there's no doubt that the CPR was necessary. He was breathing on his own when they loaded him up on the ambulance....

[macroorchidism]

did he died?

[ammarhio]

you forgot the gargling

[0000me0000myself0000]

thanks for sharing!!!

[48alfaone]

Very close, well done buddy, do you scare your wife with that, Haha! But, "All New Training": industry first aid attendants, public CPR / AED classes, police, first responders & EMS should see & study closely any & all Agonal Rhythm Videos!! Know what agonal looks like, make ALS happy, use your AED quick & give us a brady pulse to work with! Thanks.

[gothbuffy]

I was looking through youtube trying to find some instructional videos and came across this one. I read all the controversial comments and wanted to add my two cents. I've been a paramedic for 15 years and I've seen arrests that go exactly like this. For those of you arguing that agonal respirations can't look like this, please search youtube for "Bondi lifeguards bring a man back to life". Note the agonal respirations that appear as slow gasps. Also note the decorticate posturing.

[chowchowgrl]

@gothbuffy Thanks for the note on the Bondi lifeguards, agonal respirations, and decorticate posturing. That was useful.

[hwhile82]

MultiMedic911 - The Actor is a 30 year Paramedic... I think he has seen numerous cardiac arrests...

[MultiMedic911]

This 'Actor' has obviously never seen anyone have a cardiac arrest. Also, the fitting is certainly not indicative of Sudden Cardiac Arrest.

Agonal breathing is more 'gaspy' and irregular. Yet another poor example being set by FOFA ....

[BOSTONIRISH17]

+1 Mustng1987...but add salva and other fluids coming out of their mouth then its the rewal dea haha.

[mustng1987]

thats pretty damn good right there, thats exactly what I see in the field.

[newcomer9747]

@mustng1987 what's your job?

[thestretch81]

asdasdasd

[NoiseMostBeautiful]

pretty scary right there...I'm not medically trained but from what few situations I've experienced while working at a busy hospital I'd say it's CPR time after seeing someone go down like that. Can the breathing ever be gasping, choking, coughing sounds or will it sound like sleeping such as the video indicates? Good video.

[mikedef51]

The "seizure" is indicative of ventricular fibrillation in the heart following sudden onset cardiac arrest.

Cheyne-Stokes was explained below.

[tezassss]

cardiac arrest??this looked more like a seizure

[deftdrummer]

Negative Ghost Rider.

[BrendanIsCool]

HNNNNNNNG

[vampireboy1649]

waz dat fake

[mikeandsouth]

no you idiot, they happened to be filming someone and they went into cardiac arrest. They were so lucky, that they knew it'd never happan again, so they carried on filming and didn't do anything. Of course it's fake......tit

[mikeandsouth]

that was @vampireboy1649 btw

[espantalho42]

is that a cheyne-stoke rhythm?

[jumeau1]

cheyne-stokes would have regular alternating periods of apnea(no breathing) and tachypnea(quick, shallow breaths). so no, it's not. i think this would just be an example of bradypnea(less than 12 breaths per minute for an adult), but i'm not positive.

[espantalho42]

thx

[ebersolerobyn24]

I do know a family friend that died from cardiac arrest. His wife went to check on him after he stated that "he had weird chest pains and felt funny," she thought he had fallen asleep because his agonal breathing sounded like he was snoring, which is kinda what this looks like in the video. There is a difference between acute agonal resp. and severe, its good for someone who is not aware of medical symptoms to know what something like this might sound like in an emergency situation.

[kILLuMBuS]

yea he did a horrible job...doesnt sound anywhere near that

[LimpLoser]

its hard to feign agonal respiration. suffice to say this does not look ( or sound ) like agonal respiration.

[Snoopo]

Looks like he having a snooze. Spaz.

[m19508]

Wow those were the most unrealistic agonal respirations.

[RassieDog]

This is exactly what my husband did when he has his SCA. (The whole thing happened as I was looking at him.) I thought it was a seizure & although I called 911 right away I did not immediately perform CPR.

[911caddy]

Close...But not quite. I've always had my "sick" pt's go into a "tonic phase" ridgid stiff body then relax into agonal breathing.. No clonic or convulsive phase! As explained below the agonal "respirations" are not true respirations.. Kinda like a fish out of water trying to breate. Hence the guppy comment. These agonal resps do not present with expiration of air as you see and hear in this clip. Time for the precordial thump at this point.

[leviathan85]

The seizure was caused by the cardiac arrest. Please do not spread misinformation around.

[leviathan85]

You just aren't getting it. Read what I'm saying, and then re-read it until it sinks into your head. The seizure did not cause the cardiac arrest; the cardiac arrest caused the seizure, secondary to hypoxia. It happens frequently in the initial stages of sudden cardiac arrest.

[leviathan85]

OReilly,

That is entirely untrue, what are you basing that statement on? I just responded to a cardiac arrest back in January where the bystanders saw the man collapse and start seizing, and then called 911.

[leviathan85]

OReilly read this one more time: The heart of this person having seizures has ALREADY STOPPED. He is seizing because his heart stopped, and his brain is not receiving oxygen anymore. With his remaining myoglobin and muscle ATP stores, he starts to seize and give out a few last breaths before he completely ran out of ATP due to the cardiac arrest. Does this make sense now?

[saintkartano]

I was taught that agonal breathing is ineffectual breathing and indicates the person's heart is already stopped (no shockably rhythm).

[leviathan85]

That's correct. The heart may be shockable though, depending on why they went into cardiac arrest.

[rwilliamsemt]

hypoxic seizure (tonic phase)like activity is usually seen for 5-10 seconds after cardiac arrest. Then pt may show agonal gasps for the next couple minutes. Just a note: Usually agonal gasps (nicknamed :guppy breathing in the Emergency Field) Usually does not result in chest rise. It is the facial, neck and intercostal muscle memory making a failed attempt to breath without cerebral (brain) coordination and Diaphragm Muscle. Just some thoughts from myself: EMS Ed. Coordinator and Instructor.

[leviathan85]

Thanks for your input. That does make sense, as I would imagine that a muscle as large as the diaphragm would be hard to contract in a body no longer receiving oxygen and nutrient supply. However in a younger healthier person, maybe it is possible?

[queenbee345622]

I watched my dog die of heart failure, and it looked like that. His eyes were open, but he wasn't there. His lungs filled with air every 30 seconds to every minute, then released, I think, it went on for a long time, then it stopped. Then his rear leg started jerking, and after awhile he stopped moving at all. I hated to see that, but at least I was with him when he died. I buried him in my backyard after he stopped making any movements.

[Padulas]

hmm...i will try to do that,when i'll go to the restaurant. :P

[Bornn368]

Almost Close its sounds more like there sleeping and snoring than anything else.

[caseyscuba1]

this is NOT agonal breathing. I am an EMT, and have seen and HEARD it. It sounds crackly, like you have a bunch of phlem or blood in your lungs. WOW, thank GOD i wasnt taught by this Ahole

[Medic83301]

So am I ! We had a guy like that the other night. We got toned out to a domestic in which the wife of our patient hit him in the throat . He was unresponsive with agonal respirations when the cops came and a couple of them were ventilating him by BVM when we arrived . He had a weak pulse and he was intubatable . We got the tube down and hauled ass to the ER , suctioning all the way in and we were able to help save him . His wife was booked for aggravated battery .

[leviathan85]

You're referring to "death rattles", which may or may not be present in agonal respirations. This guy is a seasoned ALS paramedic with 28 years of experience in the best EMS system in the world. This video is endorsed by emergency physicians as well.

[woaikonglong]

ouch, this wants to make me go into a cardiac arrest

[marchettatench]

you idiot!!!!!!!! my son died at 18 years old from this. learn something!

[woaikonglong]

I'm premed working on speciallizing in emergency care. I was refering to the video, the acting in particular, not the condition. Perhaps you are the idiot and failed to notice that pretty much everyone else on here mentioned inaccuracy? Be more observant, don't jump to conclusions and maybe try to learn some manners in the meantime.

[emt89]

MI @ 18yo? was he born with heart probs?

[marchettatench]

we think he waws based on what the cardiologists say. we didn't know he had and arrythmia until he was 15 and started going through puberty.of course he died 3 years later after we were told that it waswnt a big deal and he would grow out of it.

[emt89]

Sorry to hear that.

[Sieverink]

I agree; this is not agonal breathing

Jan Sieverink

Instructor First Aid

[leviathan85]

How many cardiac arrest patients have you treated? Just curious...

[fightthefire21]

thats not agonal breathing... sorry...

[foxinca]

How can I make sure someone who is agonal respirations,not other happen?

And do I need to give him(or her)CPR?

[fightthefire21]

If you dont know about it and would like to, get in touch with your local fire department and see if there are any public trainings for this kind of situation...

[leviathan85]

In general, agonal breathing is very very slow (less than 10 breaths a minute) and shallow. The more important part is that you will see no signs of life, and if trained to check, no carotid or femoral pulses.

[HumanitesRottenFruit]

god thats horrible