Respiratory arrest occurs when breathing ceases completely or becomes so ineffective that it cannot sustain the body’s oxygen needs. It is a life-threatening medical emergency. Without effective breathing, the body rapidly depletes its oxygen reserves, leading to widespread cellular dysfunction.
The Body’s Response
When respiratory arrest happens, a lack of oxygen enters the lungs and bloodstream. This rapid deprivation of oxygen, known as hypoxia, directly impacts all organs and tissues. The brain is particularly sensitive to oxygen shortages; even a few minutes without it can lead to significant damage.
The body’s cells, especially those in the brain, rely on a continuous supply of oxygen to produce energy. Without this energy, cellular functions begin to fail, leading to loss of consciousness. If oxygen delivery is not restored promptly, brain injury becomes likely within three minutes, and death is almost certain after five minutes.
Recognizing the Warning Signs
Identifying respiratory arrest quickly is important. The most direct sign is the absence of normal breathing. Sometimes, breathing may appear as abnormal gasping, snorting, or gurgling sounds, often called agonal breaths. These are not effective breaths and signal an emergency.
Another significant sign is a bluish discoloration of the skin, particularly around the lips, fingertips, or nail beds, known as cyanosis. This color change indicates that the blood lacks sufficient oxygen. The affected individual will also become unresponsive to shouts or shakes, eventually losing consciousness. These signs require immediate action.
Underlying Causes
Respiratory arrest can stem from various medical conditions or traumatic events that impair the body’s ability to breathe. Airway obstruction is a common cause, which can occur when a foreign object, such as food, blocks the upper airway. Obstruction can also result from swelling in the airway, as seen in severe allergic reactions or infections.
Severe lung conditions can also lead to respiratory arrest. Examples include extreme asthma attacks, chronic obstructive pulmonary disease (COPD) exacerbations, or severe pneumonia, where the lungs cannot effectively exchange gases. Conditions affecting the central nervous system, such as a drug overdose, stroke, or head injury, can depress the brain’s respiratory control centers, causing breathing to slow or stop. Trauma to the chest, certain neuromuscular disorders, or even cardiac arrest can also precipitate respiratory arrest.
Immediate Life-Saving Actions
Responding to a respiratory arrest requires immediate action. The first step is to call for emergency medical services, such as 911 or your local emergency number. Promptly alert others nearby for assistance.
If the person is not breathing but has a pulse, begin rescue breaths. Ensure the airway is open by gently tilting the head back and lifting the chin. Administer one rescue breath every five to six seconds for adults, ensuring the chest visibly rises. Continue rescue breaths until emergency personnel arrive or the person starts breathing on their own.
If the individual is unresponsive and not breathing, and you are trained in cardiopulmonary resuscitation (CPR), initiate chest compressions. Performed at a rate of 100 to 120 per minute, chest compressions help circulate oxygenated blood to the brain and other vital organs. If cardiac arrest is suspected or breathing does not return, combine 30 chest compressions with two rescue breaths. Continue these efforts until professional help takes over. If the person becomes unconscious but is breathing normally, place them in the recovery position to help keep their airway open and prevent choking.