When someone collapses and stops breathing, identifying no breathing quickly and responding appropriately can mean the difference between life and death. Learning to recognise when a person is not breathing and knowing the essential first aid steps can save the life of a family member, colleague, or stranger. This guide will teach you the critical first aid skills every Australian should know.
Quick Recognition: Is This Unresponsive Person Not Breathing?
The first step in any first aid emergency is to check for breathing properly. Identifying no breathing accurately requires a systematic approach—when you find someone who is unresponsive, you have just 10 seconds to determine if they’re breathing normally or if you need to start CPR immediately.
The 10-Second Assessment: Begin by checking if the person is unresponsive—gently shake their shoulders and shout “Are you okay?” If someone who is unresponsive doesn’t respond, immediately check for breathing including signs to look for:
- Look at their chest for rising and falling movement
- Listen for breath sounds near their mouth and nose
- Feel for air movement against your cheek
Key Warning Signs: A person is unresponsive and not breathing if you observe:
- No chest movement for 10 seconds
- Blue or grey lips and fingernails (indicating lack of oxygen)
- Complete lack of response to your voice or touch
- No air movement from their nose or mouth
Normal vs Abnormal Breathing: Someone who is unconscious but breathing will have regular chest movements, even if their breathing may become noisy. However, if the person is unresponsive their breathing may become very shallow or stop entirely. Gasping or agonal breathing (irregular, laboured breaths) is not normal breathing—this injured person needs CPR immediately.
Don’t waste time if you’re unsure—when in doubt, it’s better to start performing CPR on someone who doesn’t need it than to delay life-saving treatment for someone who does.
DRSABCD and Your First 60 Seconds: Critical First Aid Actions
Once you’ve determined that a person is not breathing, your next actions must be swift and decisive. After identifying no breathing in the initial assessment, these first aid steps follow the DRSABCD Action Plan taught in every first aid course across Australia.
Safety First (10 seconds): Before you assist someone, ensure the scene is safe. Look for dangers like traffic, electrical hazards, or structural damage. You can’t provide first aid if you become injured yourself. If it’s safe to approach, quickly move to the unconscious person.
Call for Help Immediately (20 seconds): Call Triple Zero (000) right away—don’t delay this crucial step. If others are available, shout for help and ask someone to bring an automated external defibrillator if one is nearby. The paramedic dispatcher can provide first aid advice while help arrives.
Position the Person (20 seconds): If the person may have a spinal injury, minimise movement. Otherwise, lay them on their back on a firm surface. Kneel beside their chest and prepare to check their airway.
Open the Airway (10 seconds): This critical part of cpr involves opening their mouth to check for obvious obstructions. Then, gently tilt their head back by placing one hand on their forehead and lift their chin with your other hand. This simple action opens the airway by moving the tongue away from the back of the throat, ensuring airway patency for rescue breaths.
Perform CPR: The Life-Saving Technique
Cardiopulmonary resuscitation (CPR) is the most important first aid skill you can learn. After identifying no breathing in an unconscious person, CPR provides artificial circulation and oxygen to keep vital organs alive until help arrives.
Hand Placement and Compression Technique: To perform cpr correctly, place the heel of one hand on the centre of the person’s chest, between the nipples. Place your other hand on top, interlocking your fingers. Keep your arms straight and position yourself directly over the chest. This positioning ensures effective chest compressions that can restart circulation.
The 30:2 Cycle: Begin cpr with 30 chest compressions followed by two rescue breaths. Push hard and fast, compressing at least 5 centimetres deep at a rate of 100-120 compressions per minute. After 30 compressions, tilt their head gently back, lift their chin, and give two rescue breaths by sealing your mouth over theirs (or use mouth-to-mask techniques if available).
Effective Compression Technique:
- Press straight down with the full weight of your upper body
- Allow complete chest recoil between compressions
- Minimise interruption—continuous compressions save more lives
- Count aloud: “1, 2, 3…” to maintain proper rhythm
Rescue Breathing: After tilting their head back and lifting their chin, pinch their nose closed and create a seal over their mouth. Give each breath over one second, watching for the chest to rise. If the chest doesn’t rise, reassess the airway position—you may need to tilt the head back more or lift their chin higher.
When to Continue: Keep performing cpr without interruption until:
- The person starts breathing normally
- A paramedic takes over
- You become too exhausted to continue effectively
- An automated external defibrillator becomes available
What to Expect and When Help Arrives
Understanding what happens during and after CPR helps you stay focused and continue providing effective first aid until professional help takes over. The process from identifying no breathing to paramedic arrival can feel overwhelming, but knowing what to expect keeps you calm and effective.
How Long to Continue: You may need to perform cpr for several minutes before help arrives. In urban areas, paramedics typically arrive within 8-12 minutes, while rural response times can be longer. Providing first aid training to communities emphasises that bystander CPR dramatically improves survival rates—don’t give up.
Signs of Successful Resuscitation: While performing cpr, watch for positive signs:
- The person begins breathing normally on their own
- Colour returns to their lips and face (indicating improved oxygen levels)
- The person shows signs of consciousness or movement
- You feel a pulse return (though don’t stop to check during CPR)
If the person starts breathing normally, stop CPR and place the person on their side in the recovery position. Continue to monitor their breathing and be prepared to restart CPR if their condition deteriorates.
When the Paramedic Arrives: Professional emergency responders will take over care immediately. They have advanced equipment including:
- Mechanical CPR devices for consistent compressions
- Advanced airway management tools for better oxygen delivery
- Medications and electrical therapy options
- Equipment for safe transport to hospital
Your role shifts to providing information about what happened, how long the person was unconscious, and what first aid steps you performed.
Why Your Actions Matter: Even if the outcome isn’t perfect, your willingness to learn first aid and act in an emergency is invaluable. Brain damage from lack of oxygen begins within 4-6 minutes, so immediate bystander CPR can prevent permanent injury even when someone cannot be fully resuscitated.
Take Action: Don’t let this knowledge go unused. Enrol in a cpr course or comprehensive first aid training course. These cpr and first aid programs teach hands-on first aid techniques and give you confidence to respond in real emergencies.
Learning basic first aid isn’t just about helping strangers—it’s about being prepared to save the life of someone you love. Every Australian should have these essential first aid skills, because you never know when someone will need your help to keep breathing.
Frequently Asked Questions
What if I'm not sure whether they're breathing or not?
If you’re uncertain after your 10-second check, start CPR immediately. Identifying no breathing can be challenging in stressful situations, but it’s better to perform cpr on someone who doesn’t need it than to delay treatment for someone who does. Occasional gasping or agonal breathing isn’t normal breathing—begin cpr straight away.
Can I hurt someone by performing CPR when they don't need it?
While CPR can cause rib fractures, these injuries heal. Brain damage from lack of oxygen is permanent. If someone is truly unconscious and unresponsive, they won’t be harmed by chest compressions. The risk of not acting is far greater than the risk of acting.
What should I do if the person starts breathing normally during CPR?
Stop CPR immediately and place them in the recovery position (on their side). Continue monitoring their breathing closely and be ready to restart CPR if they stop breathing again. Keep them comfortable and reassured until help arrives.