Approach to the unresponsive patient

Checking for the breathing

keep the patient's head in the tilted position so that the airway is still open
place your ear above the patient's mouth, look at the patient's chest
check the patient's breathing for no more than 10 seconds by:
- look - look if the patient's chest is moving (when the patient wears several layers of clothing, remove some pieces of it to make the chest movement more visible)
- listen - listen to the sounds of the exhaled airflow
- feel - feel the exhaled airflow on your cheek

If you have any doubt whether the patient's breathing is normal, act as if he/she is not breathing normally and start CPR.

= agonal breathing
the patient gasps for breath
it frequently occurs in cases of cardiac arrest (more than 40 % of all cases)
it is the response of CNS to the reduced oxygen supplies
irregular, barely noticeable, noisy breathing
the patient may resemble a fish which is out of water and gasps for breath
there are no chest movements
the intervals between the breaths gradually lengthen until gasping stops completely

Gasping is not considered normal breathing. The gas exchange in the lungs is ineffective, so you have to start CPR.

When you take care of an unresponsive patient, it is always your absolute priority to control the patient's vital signs.

it includes the airway management, check for breathing and eventually starting CPR
if you have a suspicion of a spinal injury by the patient, try to avoid excessive rotation and tilting the head to the side, however, always follow the algorithm SSS ABC