Recognize cardiac arrest by two signs — no response and no normal breathing — and don't mistake agonal breathing for a sign of life.
Two signs — and nothing else
Unresponsive and not breathing normally
Cardiac arrest is recognized by two signs: the person is unresponsive and not breathing normally. Nothing else. A bystander doesn't look for a pulse — it isn't part of the definition, and seconds count.
How to check breathing. Tilt the head back, lift the chin, and look at the chest, listen, and feel for breathing with your cheek — the whole check takes no more than ten seconds. A smooth, quiet rise and fall of the chest is breathing. Occasional gasping breaths, gasps, rasping sounds, single breaths with long pauses, “like a fish out of water” — that's not breathing.
This is agonal breathing. It occurs in 30–60% of cardiac arrests, mostly early on, and the European Resuscitation Council calls it the main barrier to recognition: a bystander hears it, decides the person is breathing, and doesn't start.
A real faint is brief: the person comes to within seconds, breathing evenly. If not, or if the breathing is abnormal, it isn't fainting.
Example: A man slumps to the kitchen floor. You call out and shake his shoulders — nothing; 911 is on speaker. You tilt his head back and look, listen, and feel with your cheek for ten seconds: two rasping breaths with a pause between them. That isn't breathing. You tell the dispatcher “not breathing normally” and start compressions — how, in the next lesson.
One rule for every unclear case: if in doubt, assume it's cardiac arrest and start.
Lesson notes
Unresponsive and not breathing normally
Cardiac arrest is recognized by two signs: the person is unresponsive and not breathing normally. Nothing else. A bystander doesn't look for a pulse — it isn't part of the definition, and seconds count.
How to check breathing. Tilt the head back, lift the chin, and look at the chest, listen, and feel for breathing with your cheek — the whole check takes no more than ten seconds. A smooth, quiet rise and fall of the chest is breathing. Occasional gasping breaths, gasps, rasping sounds, single breaths with long pauses, “like a fish out of water” — that's not breathing.
This is agonal breathing. It occurs in 30–60% of cardiac arrests, mostly early on, and the European Resuscitation Council calls it the main barrier to recognition: a bystander hears it, decides the person is breathing, and doesn't start.
A real faint is brief: the person comes to within seconds, breathing evenly. If not, or if the breathing is abnormal, it isn't fainting.
Example: A man slumps to the kitchen floor. You call out and shake his shoulders — nothing; 911 is on speaker. You tilt his head back and look, listen, and feel with your cheek for ten seconds: two rasping breaths with a pause between them. That isn't breathing. You tell the dispatcher “not breathing normally” and start compressions — how, in the next lesson.
One rule for every unclear case: if in doubt, assume it's cardiac arrest and start.