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Agonal Breathing

 Importance of continued CPR

Girl swimmer, 16, died after ‘wrongly trained’ lifeguard stopped CPR thinking she had saved her life

Sophie Konderak suffered a cardiac arrest moments after starting a training session and was dragged unconscious to the poolside.

Full Story:



Heart specialist Dr Christopher Duke said Sophie ‘would have survived’ if she had received continuous CPR. He said: ‘You don’t stop resuscitation just because a patient appears to be breathing. You only stop if there’s breathing and a pulse.’

The coroner Catherine Mason said she would write to the Resuscitation Council of the UK, which provides guidelines for life-saving techniques, to ask it to amend its training guidelines to include checking for a pulse.

The inquest heard Sophie’s initial cardiac arrest was caused by an undiagnosed heart condition.

The AoFA were asked to comment on this issue.

AoFA Comment.

The casualty could have easily re-arrested causing death. Detecting a pulse (or the absence of one) would have identified the need to continue CPR. However, it is feasible the first aider misinterpreted ‘Agonal’ breathing (which is a sign of dying) with ‘Normal’ breathing (a sign of life). If this is the case, ineffective training may be the problem not the first aider or the Resuscitation Councils’ guidelines.

A first aider is not a medical professional and in this case the first aider has acted in good faith and within her training. Overall, the first aider should be praised for her actions, not criticised.

(Note: AoFA comments are based on reported news items as stated below.)
UK Resuscitation Council Guidelines:
Studies have shown that pulse checking is difficult and unreliable especially for laypersons including first aiders, Some years ago, pulse check and checking for ‘Signs of Life’ was removed from basic life support (BLS) training and replaced with a single ‘Normal Breathing’ check. This change was designed to simplify and improve the outcome of CPR.

Agonal Breathing:

Agonal breathing is present in up to 40% of pre-hospital cardiac arrests. It is important that first aiders can recognise agonal breathing .
Agonal breathing can sound like gasping, snorting, gurgling, moaning or laboured breathing. It is NOT ‘normal’ breathing.

If in doubt, do CPR. It is better to do CPR when not needed than not to do CPR when needed!

Make sure you know the difference between Normal and Agonal breathing.

There are two videos that can be watched:

http://www.youtube.com/watch?v=CBMxH4xtE8w (Acting)
http://www.youtube.com/watch?v=ICODRFoWZkw (Real incident)

Resuscitation guidelines are periodically reviewed on a worldwide basic.    The next review is due this December blog on again!

with thanks to AoFA for their continued support and information.  To view the AoFA website go to http://www.aofa.org/default.asp


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