What Is Agonal Breathing?: Causes & Treatment

ProTrainings What Is Agonal Breathing?: Causes and Treatment

Agonal breathing: a term that is not often a part of the average person’s vocabulary, and is used to define atypical respiration that can be hard to otherwise describe. But how do you recognize agonal breathing? What causes it? And how do you treat this significant sign that a person’s life is in danger?

While it’s true that it’s vitally important to know how to effectively provide CPR, it’s equally important to be able to first identify an emergency that requires CPR intervention. This is particularly true when considering the high correlation between agonal breathing and cardiac events.

What is agonal breathing, you may ask? Read on learn exactly what it is and what causes it, as well as the appropriate first aid response needed.

What Is Agonal Breathing?

Due to its irregular nature, agonal breathing is often viewed and described in a variety of ways. Essentially, it is a disruption of normal breathing patterns that results in ineffective exchanging of oxygen in and out of a person’s body.

While the person may appear to be continuing to breathe, they are actually in significant distress and in need of immediate attention. This is why more and more 911 dispatchers are being trained to help laypersons identify this type of breathing and start rendering aid as soon as possible.

Signs Of Agonal Breathing

Agonal breathing is generally described as distressed breathing in which the person has an open mouth and seems to be gulping or gasping for air, but is failing to breathe effectively. In our agonal breathing video on YouTube pictured  above / below, ProTrainings co-founder Roy Shaw gives a live example of what agonal breathing looks like.

There have been several studies on agonal breathing over the past few decades, and recent studies suggest that agonal breathing occurs in approximately 55% of all cardiac arrests. It can be a great indicator a person is in need of resuscitation. So while we know what is agonal breathing, what exactly causes this gasping reaction in cardiac arrest victims?

What Causes Agonal Breathing?

Once a person has experienced a disruption to their normal respiratory and cardiac systems, the effects can become quite serious in a few short moments. As a person’s oxygen levels decrease, their bodies become increasingly hypoxic and the body begins its fight-or-flight response.

That’s where the shortened gasping or gulping breaths of agonal breathing come in. These types of movements originate in the brainstem neurons as the higher level neurons are starved of oxygen. This reduction of oxygen in the body leading to agonal breathing is most often due to either cardiac arrest or a stroke.

ProTrainings What Is Agonal Breathing?: Causes and Treatment

Cardiac Arrest

Cardiac arrest is the disruption of normal electrical signals in the heart that cause the heart to continue to pump blood throughout the body. This generally comes on quickly and often without warning. The lack of oxygenated blood circulation is the most common trigger for agonal breathing.


A stroke is a disruption to the blood flow in the brain, either due to blockage of an artery or a burst vessel. As with cardiac arrest, this immediate drop in oxygenation to the brain can result in hypoxia, which triggers a person’s agonal breathing response.

How Do I Treat Agonal Breathing? 

When you witness a person collapse and recognize breathing similar to Roy’s demonstration in the agonal breathing video, it is a sign that this person’s life is in immediate danger.

As with any cardiac arrest victim, a bystander should immediately call 911 while others begin CPR. In following the most up-to-date CPR guidelines, chest compressions should begin as soon as possible to help restore blood flow throughout the body. This will allow the residual oxygen in the blood to reach critical areas to quell the effects of oxygen deprivation.

As mentioned in our video, 911 operators across the country are becoming more familiar with helping laypersons identify and work to treat agonal breathing and the underlying cause until emergency service personnel can arrive on the scene.

Being aware of agonal breathing and what the differences are from effective respiration is a keystone to being able to identify victims who are likely in the early stages of cardiac arrest. While we’re aware of the causes of this unique pseudo-breathing pattern, it’s more important to know what to do when time is of the essence.

That’s where being properly trained in CPR can make the difference between being another bystander and being in a position to step in and provide effective resuscitation. If you witness someone experiencing agonal breathing, remember: they need help immediately. Don’t forget to check out our video for a demonstration of what to look for. 

Contact us today to learn more about how ProTrainings can help you make getting your staff CPR certified easier and more efficient.