A bystander finds a middle-aged man collapsed on a railway platform. He is unresponsive but making slow, snoring, gasping efforts roughly every few seconds. The bystander's most appropriate action is:

• A Treat him as being in cardiac arrest and start chest compressions immediately ✓
• B Place him in the recovery position and monitor breathing
• C Wait 2 minutes to see whether normal breathing resumes
• D Give five sharp back blows between the shoulder blades

Explanation

Agonal gasps occur in up to 40 percent of witnessed arrests in the first minutes and reflect brainstem activity during ongoing fibrillation, not effective breathing. They are the commonest reason laypersons withhold CPR, so recognising them as a sign of arrest is a heavily examined teaching point. Back blows address foreign body airway obstruction, which is not described here.

Reference: AHA Guidelines for CPR and Emergency Cardiovascular Care, 2020 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.