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    Breathing - slowed or stopped

    Respiration slowed or stopped; Not breathing; Respiratory arrest; Apnea

    Breathing that slows down or stops from any cause is called apnea.

    Considerations

    Apnea can come and go and be temporary. This can occur with obstructive sleep apnea, for example.

    Prolonged apnea means a person has stopped breathing. If the heart is still active, the condition is known as respiratory arrest. This is a life-threatening event that requires immediate medical attention and first aid.

    Prolonged apnea accompanied by lack of any heart activity in a person who is not responsive is called cardiac (or cardiopulmonary) arrest. In infants and children, the most common cause of cardiac arrest is respiratory arrest. In adults, the opposite usually occurs -cardiac arrest leads to respiratory arrest.

    Causes

    Apnea can occur for many different reasons. The most common causes of apnea in infants and small children are usually different from the most common causes in adults.

    Common causes of apnea in infants and young children include:

    • Asthma
    • Bronchiolitis (inflammation and narrowing of the smaller breathing structures in the lungs)
    • Choking
    • Encephalitis (brain inflammation and infection)
    • Gastroesophageal reflux (heartburn)
    • Holding one's breath
    • Meningitis (inflammation and infection of the tissue lining the brain and spinal cord)
    • Pneumonia
    • Premature birth
    • Seizures

    Common causes of apnea in adults include:

    • Asthma or other lung diseases
    • Cardiac arrest
    • Choking
    • Drug overdose, especially due to alcohol, narcotic painkillers, barbiturates, anesthetics, and other depressants
    • Obstructive sleep apnea

    Other causes of apnea include:

    • Head or brainstem injury
    • Irregular heartbeat
    • Metabolic (body chemical, mineral, and acid-base)disorders
    • Near drowning
    • Stroke and other neurological disorders

    When to Contact a Medical Professional

    Seek immediate medical attention or call your local emergency number (such as 911) if a person with any type of breathing problem:

    • Becomes limp
    • Has a seizure
    • Is not alert (loses consciousness)
    • Remains drowsy
    • Turns blue

    If a person has stopped breathing, call for emergency help and perform CPR (if you know how). When in a public place, look for an Automated External Defibrillator (AED) and follow the directions.

    What to Expect at Your Office Visit

    CPR or other emergency measures will be done in an emergency room or by an ambulance emergency medical technician (EMT) or paramedic.

    Once the patient is stable, the health care provider will do a physical exam, which includes listening to heart sounds and breath sounds.

    Questions will be asked about the person's medical history and symptoms, including:

    • Time pattern
      • Has this ever happened before?
      • How long did the event last?
      • Has the person had repeated, brief episodes of apnea?
      • Did the episode end with a sudden deep snorting breath?
      • Did the episode occur while awake or asleep?
    • Recent health history
      • Has there been any recent history of an accident or injury?
      • Has the person been ill recently?
      • Had there been any breathing difficulty before the breathing stopped?
      • What other symptoms have you noticed?
      • What medications does the person take?
      • Does the person use street or recreational drugs?

    Diagnostic tests that may be done include:

    • Arterial blood gas
    • Chest x-ray
    • ECG
    • Other blood tests

    References

    Ward KR, Neumar RW. Adult resuscitation. In: Marx J, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 7.

    Berg MD, Nadkarni VM, Gausche-Hill M, Kaji AH, Berg RA. Pediatric resuscitation. In: Marx J, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 8.

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                Tests for Breathing - slowed or stopped

                  Review Date: 1/1/2013

                  Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

                  The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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