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Hoots : When should one stop CPR? I'm looking on various websites. They all say to stop CPR when normal breathing has started. But this news says that that is wrong and you CPR must not be stopped unless you have breathing and a - freshhoot.com

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When should one stop CPR?
I'm looking on various websites. They all say to stop CPR when normal breathing has started. But this news says that that is wrong and you CPR must not be stopped unless you have breathing and a pulse:
www.dailymail.co.uk/news/article-1253701/Girl-swimmer-16-died-wrongly-trained-lifeguard-stopped-CPR-thinking-saved-life.html
Which is correct?


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If the patient is breathing normally, stop CPR.

Image Source: Official Guidelines of the European Resuscitation Council, latest edition: 2015. Section 2, p.88
The part that made me personally most suspicious in the article was that the patient supposedly breathed for 4 minutes without pulse.

However, she did not take the crucial step of checking for a pulse - to determine whether the heart had restarted - and unwittingly left Sophie dying on the wet floor.
Paramedics arrived four minutes later and resumed CPR, only to be asked by one of the lifeguards: 'Why are you doing CPR? She's alive,' the hearing was told.

Normally breathing for 4 minutes without pulse is impossible.
Most likely in this case the patient was gulping (also known as undergoing agonal respiration). This is not considered normal breathing and requires CPR.
The lifeguard took it as "normal breathing" and discontinued CPR wrongfully.

How to detect agonal breathing
Here is a video of a real resuscitation and from 2:40 onwards it's a good example of agonal breathing.
The procedure followed in this video is outdated, but it's a great example of agonal breathing. The newest guidelines can be found here.


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