Gasping Is Good When It Comes to Cardiac Arrest

MONDAY Nov. 24, 2008 -- Call it what you will -- gasping, gurgling, moaning -- but noisy breathing increases the chances for survival when someone is suffering sudden cardiac arrest, a new study shows.

The recipe for action calls for swiftness; Call 911 to get emergency medical help and start compressing the chest, 100 times a minute.

The study of 1,218 cases reported in the Phoenix area showed better survival when abnormal breathing -- gasping -- was noted, said Dr. Gordon A. Ewy, chief of cardiology at the University of Arizona, and a member of the team reporting the findings in the Nov. 25 issue of Circulation.

Many bystanders don't recognize abnormal breathing as a danger sign, Ewy said. "They call 911 and say that someone has fainted," he said. "When they are asked, 'Are they breathing,' they say, 'Oh yeah, they are breathing,' so no one is dispatched. Four or five minutes later, the person stops breathing and they call 911 again. That four or five minutes probably cost the patient his life."

One problem is the difficulty in finding the word to describe the abnormal breathing pattern, Ewy said. "The most common description is snoring," he said. "A wife will say, 'My husband was snoring at night,' and she woke up to find him dead."

The Arizona study found gasping in 39 percent of the cases of sudden cardiac arrest. Bystanders performed emergency cardiac measures, such as cardiopulmonary resuscitation (CPR), about 40 percent of the time for gaspers and non-gaspers. Among those who got emergency help from bystanders, 39 percent of the gaspers survived, compared to just 9.4 percent of the non-gaspers.

For those who didn't get bystander help, the survival rate was 21.1 percent for gaspers and 6.7 percent for non-gaspers, the study said.

The odds of gasping -- and of survival -- decreased steadily the later that emergency medical service was administered.

Bystander action is vital, Ewy said. "If you call 911 and just stand there, you might as well sign their death certificate," he said.

Action can help even if no abnormal breathing is evident, Ewy said. "If you start early enough and do a good job, some of these people will start gasping," he said.

Dr. Vinay Nadkarni is an associate professor of anesthesia and critical care medicine at the University of Pennsylvania, and a spokesman for the American Heart Association. "The big message to the lay public is that you can make a difference and save a life," he said. "If they can recognize this breathing pattern as abnormal, all they have to do is call 911 and push hard on the chest."

Gasping is a sign that there's still blood flow to the brain, and the person can be saved even though the heart has stopped, Nadkarni said.

"More and more people now are willing to do CPR," he said. "But there is information that they might not be starting it soon enough. An abnormal, gasping breathing pattern is consistent with cardiac arrest and calls for immediate action."

Posted: November 2008


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