If someone stops breathing, call 911 immediately and start chest compressions. Every minute without action reduces the chance of survival, so speed matters more than perfection. The steps you take in the first few minutes can keep blood and oxygen flowing to the brain until paramedics arrive.
What you do next depends on why the person stopped breathing. The core response is the same: call for help, push hard and fast on the chest, and use an AED if one is available. But certain situations, like drowning, choking, or opioid overdose, require slightly different approaches.
Check for Responsiveness First
Tap the person firmly on the shoulders and shout their name. If they don’t respond, check for breathing by watching their chest for 10 seconds. Look for the rise and fall of the chest and listen for air moving in and out.
One critical mistake bystanders make is confusing gasping with normal breathing. Gasping can sound like snoring, gurgling, moaning, or snorting. A person who is gasping is not breathing adequately. They need chest compressions right away. Bystanders often hear these sounds and assume the person is okay, which delays lifesaving action. If the person is unresponsive and either not breathing or only gasping, treat it as a cardiac arrest.
Call 911 and Start Chest Compressions
Call 911 yourself or tell someone nearby to do it. Put the phone on speaker so you can talk to the dispatcher while you work. Dispatchers are trained to walk you through exactly what to do for a breathing emergency, including chest compressions, airway maneuvers, and choking relief. Follow their instructions if you’re unsure about any step.
If you have no CPR training, or you’re trained but not confident, do hands-only CPR. Place the heel of one hand in the center of the person’s chest, put your other hand on top, and push hard and fast. Aim for 100 to 120 compressions per minute, which is roughly the tempo of the song “Stayin’ Alive.” Push at least 2 inches deep, but no deeper than about 2.4 inches, as going too deep can cause injuries. Let the chest come all the way back up between each push. Don’t stop until emergency medical help arrives or the person starts moving and breathing normally.
If you’re trained in CPR and feel confident, check for a pulse within 10 seconds. If there’s no pulse, start with 30 chest compressions followed by 2 rescue breaths. Tilt the head back, lift the chin, pinch the nose shut, and blow into the mouth until you see the chest rise. Repeat the cycle of 30 compressions and 2 breaths continuously.
The American Heart Association emphasizes that pushing hard and fast on the chest is the single most important thing a bystander can do. Even without rescue breaths, chest compressions alone keep blood circulating to the brain and vital organs.
Use an AED if One Is Available
Automated external defibrillators are found in many public buildings, gyms, airports, and offices. If someone nearby can grab one while you do compressions, use it as soon as it arrives. AEDs are designed for untrained people and give spoken instructions step by step.
Remove all clothing from the person’s chest and wipe it dry if needed. Place one adhesive pad on the upper right side of the chest and the other on the lower left side, a few inches below the left armpit. The machine will analyze the heart rhythm and tell you whether to deliver a shock. If it advises a shock, make sure no one is touching the person and press the button. Resume chest compressions immediately after the shock.
For children under 8 or weighing less than 55 pounds, use pediatric pads if the AED has them. If the pads are too large and might touch each other on a small chest, place one pad in the middle of the chest and the other on the back between the shoulder blades.
CPR for Infants and Small Children
The technique changes for babies under 12 months old. Use two fingers (not your whole hand) placed on the center of the chest, and compress to a depth of about 1.5 inches. The rate stays the same: 100 to 120 compressions per minute. Give 30 compressions followed by 2 gentle rescue breaths, covering both the baby’s mouth and nose with your mouth.
For children aged 1 to 8, you can use one hand instead of two for compressions, depending on the child’s size. Push about 2 inches deep. Rescue breaths are especially important for children because their cardiac arrests are more often caused by breathing problems than by heart rhythm issues.
If You Suspect an Opioid Overdose
Opioid overdoses have distinct warning signs: the person is unconscious and can’t be woken up, their breathing is very slow or shallow (or has stopped entirely), and their lips or fingernails may be turning blue or purple. You might also hear choking sounds or a gurgling noise.
First, try to rouse the person. Call their name loudly. If that doesn’t work, grind your knuckles firmly into their breastbone or rub knuckles across their upper lip. If they respond, keep them awake and monitor their breathing.
If they don’t respond, call 911 and administer naloxone if you have it. Naloxone nasal spray comes in a prefilled, needle-free device that requires no assembly. Insert the nozzle into one nostril and press the plunger to deliver the full dose. If the person doesn’t respond within 2 to 3 minutes, give a second dose in the other nostril. Each package contains two doses for this reason. While waiting for naloxone to take effect, provide rescue breathing or chest compressions if the person isn’t breathing on their own. Naloxone is available without a prescription at most pharmacies.
If the Person Was Drowning
Drowning victims stop breathing because their airway is blocked by water, so getting air into the lungs is the priority. The recommended approach starts with 5 initial rescue breaths before beginning chest compressions, rather than the standard 2 breaths used in typical CPR. After those 5 breaths, continue with the normal cycle of 30 compressions and 2 breaths.
Only attempt a water rescue if you can do so safely. Pull the person to land or a stable surface before starting CPR. Chest compressions are not effective in the water.
If the Person Was Choking
A choking person who loses consciousness and stops breathing needs a modified approach. Lower them onto their back on the floor. Before starting chest compressions, open their mouth and look inside. If you can see the object blocking the airway, reach in with a finger and sweep it out. Don’t do a blind finger sweep if you can’t see anything, as you risk pushing the object deeper.
Then begin standard CPR with chest compressions and rescue breaths. Each time you open the airway to give a breath, look in the mouth again for the object. The chest compressions themselves can help dislodge whatever is stuck.
After the Person Starts Breathing Again
If the person begins breathing on their own but remains unconscious, place them in the recovery position to keep their airway clear. Roll them onto their side, adjust the top leg so both the hip and knee are bent at right angles (this keeps them from rolling onto their face), and gently tilt the head back to keep the airway open. Stay with them and monitor their breathing continuously until paramedics arrive.
Do not leave someone who has stopped breathing and been resuscitated alone, even if they seem stable. Their condition can deteriorate again quickly, especially in cases of opioid overdose where naloxone may wear off before the drug does. Keep watching their chest rise and fall, and be ready to restart compressions if breathing stops again.