Agonal breathing

Published

I'm a new nurse and had a question about agonal breathing. We had a patient in her early 20s who had a bad reaction to Xanax and suffered severe respiratory depression, so severe that she went into agonal breathing. Her VS remained stable and her O2 sat. remained at 100%. ABG's showed alkalosis. Is it normal for the pulsox to show 100% oxygenation with agonal breathing?:confused: My only other experience with this was with an older woman before she died, and she was de-satting; but I also know that that is the process with death. I'm curious to know what's the "norm" as far as VS during agonal breathing. Does the body just compensated better in young people? Thank you!

Up Vote Up Vote ×

Ventilation and oxygenation are two different concepts. Hold your breath, you are not ventilating, but you are oxygenating just fine. I just left a thread where we are talking about this very subject. In fact, with good preoxygenation, a "normal" patient can go up to 8 minutes without breathing before their saturation falls below 90%. However, I would expect their CO2 to indicate a lack of ventilation. Also, an alkalotic ABG tells us little. Was the alkalosis of metabolic or respiratory etiology?

Up Vote Up Vote ×

That's certainly a help! Thank you! The alkalosis was respiratory.

Up Vote Up Vote ×

How can I link to the thread you referenced?

Up Vote Up Vote ×
That's certainly a help! Thank you! The alkalosis was respiratory.

If the patient was really hypoventilating, I would find the presence of a respiratory alkalosis very unusual. Perhaps this patient had a breathing pattern that was mistaken for agonal respirations?

Up Vote Up Vote ×
How can I link to the thread you referenced?

I think you can select my name and search my recent posts. I believe the name of the thread is "respiratory arrest."

Up Vote Up Vote ×

Isn't this why in an emergency you can do cpr with just chest compressions?

Up Vote Up Vote ×

Thank you, Gila RN, for referencing the thread on "respiratory arrest." It was an excellent discussion and I found it very helpful.

Up Vote Up Vote ×
Specializes in pediatrics.

This reminds me of a pt my fellow nurse had. The kiddo was grunting, deep retractions, bilat wheezes, acute respiratory distress totally. In report, the nurse got, "Oh, he's fine, satting at 100%. Yeah he's on oxygen, 6L face mask."

Sometimes O2sats can mean something totally different if the pt's on room air vs face mask/nasal cannula/O2 therapy.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Isn't this why in an emergency you can do cpr with just chest compressions?

EXACTLY!

Up Vote Up Vote ×
Specializes in ICU, ER, EP,.
EXACTLY!

NO!!!!!!!!!!!!!!

LOOK at you're BLS... if not breathing or it is agonal.. but sats are good.. you have time for narcan or romazicon while you breathe for the patient or supply O2.

FTLOG ,,, you only do CPR when there is NO PULSE... you can have a minimal breather with a solid pulse so NEVER EVER do CPR without checking the pulse, cripes sakes.!!!!!!!!!

In this case you had time to provide O2, put on a continious sat monitor and ambu or bag until it worked. Next, check pulse... don't just jump on a chest and do cpr for crying out loud.

reverse your drugs if given the chance and give O2 or breathe for them. Many times you'll get them back or have to intubate them but NEVER EVER do CPR on a respiratory arrest... geeze I need a valium myself now:uhoh3:

not being nasty to OP, but to the crap you've been told to do by others whom will not be named, zeeze!:down:

Up Vote Up Vote ×
Specializes in NICU.

I think you need to read the other posts more carefully. NO-ONE told the OP she should have done CPR. She was simply asking why the sats were 100% with agonal breathing. A few of the previous posters were making reference to why hands only CPR is effective. Calm down and read more carefully before being so nasty.

NO!!!!!!!!!!!!!!

LOOK at you're BLS... if not breathing or it is agonal.. but sats are good.. you have time for narcan or romazicon while you breathe for the patient or supply O2.

FTLOG ,,, you only do CPR when there is NO PULSE... you can have a minimal breather with a solid pulse so NEVER EVER do CPR without checking the pulse, cripes sakes.!!!!!!!!!

In this case you had time to provide O2, put on a continious sat monitor and ambu or bag until it worked. Next, check pulse... don't just jump on a chest and do cpr for crying out loud.

reverse your drugs if given the chance and give O2 or breathe for them. Many times you'll get them back or have to intubate them but NEVER EVER do CPR on a respiratory arrest... geeze I need a valium myself now:uhoh3:

not being nasty to OP, but to the crap you've been told to do by others whom will not be named, zeeze!:down:

Up Vote Up Vote ×
+ Join the Discussion