FAQ

Normal breathing is steady, quiet, and happens twelve to twenty times per minute in adults. Agonal breathing is irregular, loud, and happens only two or three times per minute, sometimes less. Normal breathing delivers oxygen to the blood. Agonal gasping does not. Anyone showing agonal breathing while unresponsive is in cardiac arrest and needs CPR.

The simplest way to tell the difference is to look at the whole picture. A person breathing normally will be responsive, with a regular chest rise and fall and quiet airflow. A person with agonal breathing will be unresponsive, with infrequent gasps and often a snoring or gurgling sound. The chest may move briefly between gasps before stopping altogether.

If you cannot tell whether breathing is normal, treat it as not normal. The cost of starting CPR on someone who turns out to be fine is minor. The cost of not starting CPR on someone in cardiac arrest is fatal.

Category: Cardiac Arrest

Yes. If someone has collapsed, is unresponsive, and is gasping or breathing abnormally, treat it as cardiac arrest. Call 999 and start chest compressions straight away. The 999 dispatcher will guide you through what to do. Do not wait to see whether the gasping stops first. Every minute without CPR cuts the chance of survival.

Gasping during cardiac arrest is called agonal breathing, and it is not effective breathing. The person is not getting any oxygen. Bystander hesitation is one of the biggest factors in poor cardiac arrest outcomes in the UK. A common reason for hesitation is uncertainty about whether the person is really not breathing.

If you are unsure, start CPR. The Resuscitation Council UK and every major guideline are clear: if someone is unresponsive and not breathing normally, begin chest compressions. You will not harm a person who turns out to be alive, and you may save the life of someone in cardiac arrest.

Category: CPR

No. Agonal breathing is a brain stem reflex, not real breathing. The person is unresponsive, the heart is not circulating blood, and oxygen is not reaching the body. Without immediate CPR and defibrillation, they will die.

This is one of the most dangerous misunderstandings in bystander response to cardiac arrest. Because the chest still moves and there is still some sound of breathing, witnesses often assume the person is breathing normally. They wait for paramedics instead of starting CPR. By the time help arrives, the chance of survival has often gone.

If someone is unresponsive and you see agonal breathing, treat it as cardiac arrest. Call 999 and start chest compressions. You cannot make things worse, but you can save a life.

Category: Cardiac Arrest

Agonal breathing usually lasts a few minutes after someone goes into cardiac arrest. Some people stop gasping within thirty seconds, while others continue for several minutes. Once the gasps stop, the person has gone into full respiratory arrest. CPR should already be underway by that point.

The length of time agonal breathing continues is not a useful measure of how long someone has left. The brain begins to suffer damage from lack of oxygen within four to six minutes of cardiac arrest. Survival drops sharply with every minute that passes without chest compressions and a defibrillator. Do not wait for the gasping to stop. Start CPR as soon as you recognise it.

Category: Cardiac Arrest

Agonal breathing usually sounds like loud snoring, gurgling, choking, or moaning. Some people describe it as a wet rasping noise or a low groan. It is not the soft, regular sound of normal breathing, and it comes in slow gasps rather than a steady rhythm.

Witnesses often describe being startled by how loud the sound is. It can be loud enough to wake someone in another room, which is sometimes how a cardiac arrest at home is first noticed. Despite how dramatic the sound is, the person making it is unresponsive and not breathing properly.

Category: Agonal Breathing

In the UK, CPR training is available through several organisations:

St John Ambulance (sja.org.uk) — offers face-to-face courses, online learning, and free resources including video guides.

British Red Cross (redcross.org.uk) — provides face-to-face and blended learning CPR courses.

St Andrew’s First Aid (firstaid.org.uk) — based in Scotland, provides first aid and CPR training.

NHS and ambulance services — many ambulance trusts offer free community CPR training. Contact your local ambulance service to find out what is available in your area.

Resuscitation Council UK (resus.org.uk) — provides guidance on CPR training standards and a directory of recognised training providers.

Free online resources — the British Heart Foundation’s Heartstart programme and Resuscitation Council UK both offer free instructional videos and guides. These are not a substitute for hands-on practice but are a useful introduction.

You do not need formal training to act in a cardiac arrest emergency — calling 999 and following the dispatcher’s instructions is sufficient. However, even a short training course significantly increases confidence and effectiveness.

Category: Practical Issues

If the person starts to show signs of life during CPR \u2014 normal breathing, coughing, purposeful movement, or opening their eyes \u2014 stop CPR and assess them.

If they are breathing normally, place them in the recovery position: roll them onto their side, tilt the head back to keep the airway open, and bend the top knee forward to stabilise them. Stay with them and monitor their breathing until the ambulance arrives.

Do not leave them unattended. If they stop breathing again, restart CPR immediately.

If they are not breathing normally despite showing some movement, continue CPR.

Tell the 999 dispatcher what has changed \u2014 they will advise you on what to do next.

Category: Cardiac Arrest

Using an AED is straightforward. The device is designed for bystanders with no medical training and gives clear spoken and visual instructions at every step.

1. Switch the AED on. Most devices power on when you open the lid or press a button.

2. Follow the spoken instructions. The AED will tell you exactly what to do.

3. Attach the pads. Remove or cut through clothing to expose the bare chest. Peel the pads from their backing and attach them in the positions shown in the pictures on the pads themselves \u2014 one below the right collarbone, one on the left side below the armpit.

4. Let the AED analyse the heart rhythm. Stay still and make sure no one is touching the person while the AED analyses. It will tell you not to touch.

5. Deliver a shock if advised. If a shock is needed, the AED will charge and tell you to press the shock button (or, on fully automatic devices, will deliver the shock itself). Make sure no one is touching the person before pressing the button.

6. Resume CPR immediately. As soon as the shock is delivered, restart chest compressions. The AED will prompt you to continue CPR and will analyse the rhythm again after two minutes.

If the AED advises no shock is needed, continue CPR. The AED will reassess regularly and advise if a shock becomes appropriate.

You cannot accidentally shock someone who does not need it \u2014 the AED will only allow a shock if the rhythm requires it.

Category: Defibrillators

Continue CPR without stopping until one of the following happens:

A defibrillator (AED) arrives and is ready to use \u2014 follow the AED’s instructions, which will tell you when to stop compressions for a shock and when to resume.

The ambulance crew arrives and takes over \u2014 tell them how long you have been doing CPR and whether the AED has been used.

The person starts showing clear signs of life \u2014 normal breathing, coughing, or purposeful movement. If this happens, stop CPR, place them in the recovery position if they are breathing, and stay with them until the ambulance arrives.

You are physically unable to continue \u2014 if there is anyone else present, ask them to take over. Even brief pauses in compressions reduce the chance of survival, so try to swap with as little interruption as possible.

Do not give up before the ambulance arrives unless you are physically unable to continue. People have survived after prolonged CPR. The 999 dispatcher will stay on the line with you and can advise.

Category: Cardiac Arrest

Push down firmly to a depth of 5\u20136cm \u2014 roughly a third of the depth of the chest. This sounds deep but is necessary to actually compress the heart and pump blood. Light or shallow compressions do not move enough blood to be effective.

Allow the chest to fully recoil (rise back up) between each compression. Leaning on the chest prevents the heart from refilling between compressions.

If you are worried about causing injury, it is worth knowing that rib fractures do sometimes occur during effective CPR \u2014 particularly in older adults. A broken rib is a treatable injury. Cardiac arrest without CPR is not survivable. Effective CPR is always worth any risk of minor injury.

Category: CPR

You do not need to give rescue breaths. Hands-only CPR \u2014 continuous chest compressions without rescue breaths \u2014 is recommended by Resuscitation Council UK for bystanders who are untrained, unwilling to give rescue breaths, or unable to do so.

In the first few minutes after a cardiac arrest, the blood still contains enough oxygen to supply the brain and heart if compressions are delivered promptly and continuously. Stopping to give rescue breaths interrupts blood flow and is less important than maintaining continuous, high-quality compressions.

If you have been trained in CPR and are confident giving rescue breaths, a ratio of 30 compressions to 2 rescue breaths is recommended. But if you are not confident with rescue breaths, do not let that stop you from doing compressions \u2014 hands-only CPR is highly effective and far better than doing nothing.

The only situation where rescue breaths are considered more important is cardiac arrest in children, where the arrest is more likely to be caused by a breathing problem. In this case, if you can, five initial rescue breaths followed by 30:2 CPR is recommended \u2014 though again, compressions alone are better than nothing.

Category: CPR

Yes. When you call 999 about a cardiac arrest, the emergency dispatcher can guide you through CPR step by step over the phone \u2014 even if you have never done it before and feel completely unsure. This is called dispatcher-assisted CPR or telephone CPR.

The dispatcher will ask you a few quick questions to confirm the person is in cardiac arrest, then give you clear, calm instructions on where to place your hands and how fast to compress. You do not need to remember anything in advance \u2014 just call 999 and follow what you are told.

Telephone CPR has been shown to increase bystander CPR rates and improve survival. Do not hesitate to call because you are worried about doing it wrong. The dispatcher is there to help you.

If someone else is with you, one person can stay on the phone with the dispatcher while the other does the compressions.

Category: CPR

A person is likely to be in cardiac arrest if they are unresponsive and not breathing normally. The key signs are:

Unresponsive: they do not react when you tap their shoulders and call to them.

Not breathing normally: they are making no breathing movements, or they are making occasional gasping or snorting sounds. These gasps \u2014 known as agonal breathing \u2014 are a sign of cardiac arrest and should not be mistaken for normal breathing.

You should not spend more than 10 seconds checking for breathing. If you are not sure whether someone is breathing normally, treat them as if they are in cardiac arrest \u2014 call 999 and start CPR immediately.

You do not need to check for a pulse. Unless you are a trained healthcare professional, pulse checks are unreliable and take too long. If someone is unresponsive and not breathing normally, start CPR. You cannot make the situation worse by acting.

Category: Cardiac Arrest

If you find someone who has collapsed and is unresponsive, follow these steps:

1. Check for danger. Make sure it is safe to approach.

2. Check for a response. Tap their shoulders and shout "Are you alright?"

3. Call for help. Shout for someone nearby to help you.

4. Open the airway. Tilt the head back gently and lift the chin.

5. Check for normal breathing. Look, listen, and feel for no more than 10 seconds. Occasional gasps are not normal breathing.

6. Call 999 immediately \u2014 or ask someone else to call while you start CPR. Tell the dispatcher the person is not breathing. They will guide you through CPR.

7. Send someone for the nearest AED. Ask a bystander to find one \u2014 the 999 dispatcher can give the location of the nearest registered device.

8. Start CPR. Place both hands on the centre of the chest and push down hard and fast \u2014 5\u20136cm deep at 100\u2013120 compressions per minute. Do not stop until the ambulance arrives or an AED is ready.

9. Use the AED as soon as it arrives. Switch it on and follow the spoken instructions.

If there are other people with you, one person should do CPR while another calls 999 and a third goes for the AED. Do not leave the person alone if you can help it.

Category: Cardiac Arrest

Yes, and this is particularly true when CPR is performed on a loved one — one of the most distressing experiences a person can face. You were trying to keep someone alive, possibly not knowing whether your efforts were working. That is deeply traumatic, regardless of the outcome.

People who have performed CPR commonly report intrusive thoughts and flashbacks replaying the moment of collapse or the resuscitation itself, guilt about whether they started quickly enough or did it correctly, hypervigilance about the survivor’s health, fear of being left alone with them, and difficulty sleeping.

It is important to know that guilt about CPR performance is extremely common and almost never warranted. Even trained paramedics do not perform CPR perfectly under stress. Imperfect CPR is far better than no CPR, and the fact that you acted almost certainly made a difference.

If you are struggling with distressing thoughts, difficulty sleeping, anxiety, or low mood, please talk to your GP. Effective treatments are available, including trauma-focused CBT and EMDR. You can also contact SCA UK for peer support from others who have been through similar experiences.

Category: Psychological Support

No. If you used an AED promptly and correctly, you did everything right. Unfortunately, not every person in cardiac arrest can be saved, even with fast and accurate treatment. Some underlying medical or cardiac conditions mean that ventricular fibrillation cannot always be corrected by defibrillation, regardless of how quickly it is delivered.

Acting quickly and using the AED gave that person the best possible chance. That matters, even when the outcome is not what you hoped for. If you are struggling with the experience, please talk to your GP or contact SCA UK for peer support.

Category: Cardiac Arrest

If bystanders who witness a cardiac arrest perform CPR, sufficient blood containing oxygen will reach the brain, heart and other organs to keep the person alive for several minutes. CPR by itself will not restart the heart, but it ‘buys time’ for the emergency medical services to reach the scene. Effective CPR more than doubles the chance of someone surviving a cardiac arrest.

Category: Cardiac Arrest

No. In the UK, it is very unlikely that someone who acted in good faith when trying to help a person in cardiac arrest would face any legal liability. No action has ever been successfully brought against a bystander who performed CPR in the UK. The courts look favourably on those who go to the assistance of others in an emergency, and performing CPR on someone in cardiac arrest cannot make their situation worse. If you are concerned, the important thing is simply to act — calling 999, starting CPR, and using a defibrillator if one is available. For specific legal questions, the Resuscitation Council UK provides further guidance.

Category: Practical Issues

CPR stands for cardiopulmonary resuscitation. It is an emergency procedure used when someone’s heart has stopped beating, to keep oxygenated blood circulating to the brain and vital organs until the heart can be restarted — either by a defibrillator or by the heart resuming on its own.

CPR combines two elements: chest compressions, which manually pump the heart, and rescue breaths, which deliver oxygen to the lungs. For bystanders without training, hands-only CPR — chest compressions alone — is recommended by Resuscitation Council UK and is just as effective for the first few minutes after a cardiac arrest.

To perform hands-only CPR:

1. Call 999 immediately. The dispatcher will guide you through CPR if you are unsure.
2. Place the heel of one hand on the centre of the person’s chest (on the lower half of the breastbone). Place your other hand on top and interlock your fingers.
3. Press down hard and fast — aim for a depth of 5–6cm and a rate of 100–120 compressions per minute. The Resuscitation Council UK suggests the rhythm of the song Stayin’ Alive as a guide to rate.
4. Keep going without stopping until the ambulance arrives or an AED is ready to use.

Even imperfect CPR is far better than no CPR at all.

Category: CPR