Normal Breathing or Not? Decide in Ten Seconds

In groups of three, an actor secretly plays a breathing pattern and the rescuer decides within 10 seconds whether to start CPR or use the recovery position. It trains the hardest step in the chain: recognizing cardiac arrest, including agonal breathing (gasping), which is not normal breathing.

How to play

1. Briefing: check for a response, open the airway with head tilt–chin lift, and look, listen and feel for normal breathing for no more than 10 seconds; if they aren't breathing or breathing abnormally, call 911, get an AED and start compressions (4 min).
2. Trios with roles: actor, rescuer and observer with a stopwatch. The actor draws a card (normal breathing, slow irregular gasping, not breathing, responsive but confused) and acts it out without saying it (6 min).
3. The rescuer decides out loud ("starting CPR" or "recovery position and monitoring") and the observer checks the time and decision against the card; rotate every case (4 min).
4. Debrief: which cases caused doubt, and why you treat it as cardiac arrest when unsure (6 min).

Rules

• No compressions on the actor: the rescuer only holds hands above the chest.
• Head tilt–chin lift is done gently and with the actor's OK.
• The actor can stop at any time by raising a hand.
• Breathing check: 10 seconds max, timed.

Variations

Adaptations

• Visually impaired students: rely on hearing and feeling air on the cheek; the actor exaggerates the gasping sound.
• Students who don't want to lie down: play observer, or rescue a cushion while a partner provides the voice.
• Deaf or hard-of-hearing students: gasping is shown with very visible chest and mouth movement.

Learning goals

• Recognize cardiac arrest in under 10 seconds.
• Tell normal breathing from gasping.
• Choose between CPR and the recovery position with clear reasons.

Equipment for a class of 25

• mats: 10
• case cards: 40
• stopwatches: 10

Teacher tip

Model the gasping yourself first so they know what it looks like: slow, noisy, widely spaced breaths. The usual mistake is reading it as "breathing" and not starting CPR; current guidance is clear that when in doubt, you start CPR.

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