Spot a Gasp, Stop a Death

Agonal breathing or gasping is an early indicator of cardiac arrest and the first sign that CPR+AED should be applied immediately. Unfortunately, survival opportunities are often lost due to a lack of understanding and recognition of gasping. The Knowledge, Attitudes & Practices (KAP) of CPR+AED Survey in 2020 revealed more than half of the respondents were unsure if they should start CPR for someone gasping.

To help members of the public better identify this symptom, Project Heart 2021 invited Prof Lim Swee Han, Chairman of Singapore Resuscitation and First Aid Council, and Mr Chu Tommy, a CPR+AED instructor and a community first responder, to shed light on gasping.

Key points from the discussion:

Is it common for a cardiac arrest casualty to experience agonal breathing?
Yes, it is common for the casualty to have agonal breathing or gasp in the first few seconds of cardiac arrest. Based on an American Heart Association Journal in 2008, 39% of the cardiac arrest patients attended by the Phoenix Fire Department Regional Dispatch Center experienced gasping . Administering CPR during this time will provide this group of casualties with a better outcome.

What should we do when we are unsure if a casualty is gasping? How important is it to recognise the difference between gasping and breathing difficulty?
When you approach a victim, the first thing to do is check for consciousness by tapping on the casualty’s shoulder and shouting, “Hello, hello, are you okay?”. If the casualty is unconscious and there is gasping movement, the casualty is most likely suffering from a cardiac arrest.

Call 995. The SCDF emergency dispatchers can guide you in identifying if the casualty is gasping or breathing normally. And if unsure, it is recommended to start chest compression. The benefits of starting chest compression on a cardiac arrest casualty outweigh the risk of performing chest compression on people who do not have cardiac arrest.

Are there any other signs of cardiac arrest that we can look out for?
You can look at the rise and fall of the chest. When a person is breathing normally, his chest will move up and down once every 5 seconds. If the movement between each breath takes more than 5 seconds, you can strongly suspect that the person may be gasping. If you are unsure, it is better to err on the safe side and proceed with CPR. It is better than not doing anything to the casualty.

Catch the full discussion here: