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What is the Difference Between Death Rattle and Agonal Breathing?

When someone is in cardiac arrest, lack of oxygen can trigger an emergency response that causes someone to start gasping for air, known as agonal breathing. This is different than a “death rattle”, which is a gurgling noise people can make while they’re dying.

However, agonal breathing can also indicate someone is dying. Here’s how to understand the difference between agonal breathing vs. death rattle, and how CPR training can prepare you to save someone’s life.

What is Agonal Breathing

Agonal breathing is a medical term used to describe someone gasping for air. This is usually a sign that the heart isn’t circulating enough or any oxygenated blood, or something is blocking air from getting into the lungs.

What Does Agonal Breathing Sound Like?

Agonal breathing can sound like gasping, snorting, moaning, or labored breathing. Gasping for breath can last for a few breaths or hours depending on the cause. If someone is experiencing agonal breathing, they are still alive. However, if someone is experiencing agonal breathing, end of life may be imminent.

How Long Does Agonal Breathing Last?

Depending on the cause, agonal breathing can last a few breaths, minutes, or hours. End of life agonal breathing may last a few minutes if cardiopulmonary resuscitation (CPR) or other emergency care is not administered. Brain cells can start dying just 5 minutes after oxygen supply is cut off, which can lead to severe brain damage or death.

What Causes Agonal Breathing?

Agonal breathing is typically caused by cardiac arrest. During cardiac arrest, the heart suddenly stops beating and blood is no longer pumped to the brain and other vital organs. As a result, there is not enough oxygenated blood circulating through the body to support functions like breathing. Specifically, the brain stem attempts to get more oxygen into the body, triggering agonal breathing.

Other causes of agonal breathing include:

  • Airway obstruction: If someone is choking or has an object blocking their airway, agonal breathing can occur as the body tries to get more oxygen.
  • Ischemic stroke: Blocked or ruptured blood vessels in the brain can disrupt oxygen flow, leading to agonal breathing.
  • Imminent death: If someone is dying, oxygen levels decrease as the body shuts down.

In cases where someone is having a stroke or experiencing airway obstruction, the heart is still beating weakly. However, lack of oxygen is still an issue.

What is Death Rattle?

Death rattle is a wet, gurgling sound people may make when they’re dying. It is caused by saliva or mucus accumulating in the airway as the body shuts down.

What Causes Death Rattle?

As someone is dying, the muscles that help someone cough and swallow stop working. As a result, the dying person is unable to swallow mucus or saliva. These fluids will start to build up in the throat and upper airways. As air passes through, this fluid buildup causes a rattling or gurgling noise.

How Long Does Death Rattle Last?

It’s estimated that nearly half of people dying experience death rattle. The abnormal noise usually starts a few hours before someone dies, but it may continue for a few days.

Agonal Breathing vs Death Rattle

Agonal breathing is caused by a lack of oxygen, while death rattle is caused by fluid buildup in the airways. These abnormal breathing patterns sound distinctly different. Agonal breathing sounds like gasping or shallow breaths. Death rattle sounds like wet, gurgling breaths.

Both agonal breathing and death rattle can be signs of bodily distress and that a person is near death. However, CPR can save someone’s life if they are experiencing agonal breathing caused by cardiac arrest. If airways obstruction is causing agonal breathing, the Heimlich Maneuver can also help unblock the airway and restore breathing. If someone is experiencing death rattle, the body is shutting down due to a cause of death that cannot be reversed

Save a Life with Online CPR Certification Training

The American AEDCPR Association has been providing online CPR, AED, First Aid, and Bloodborne Pathogens training since 1999. Designed for healthcare professionals and anyone who desires CPR certification, AEDCPR offers online courses to satisfy the requirements for Basic CPR, BLS, Healthcare Provider BLS, CPR-C Course, Professional Rescuer CPR, and all AED certifications.

Taking the online BLS (Basic Life Support) certification class covers the basics of cardiopulmonary resuscitation (CPR), foreign-body airway obstruction (Heimlich Maneuver), and using an automated external defibrillator (AED). If someone is experiencing agonal breathing, these techniques can offer life-saving interventions.

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