BREATHING EMERGENCIES
Introduction
When you breathe air into your lungs, the oxygen in the
air is transferred to the blood.
NORMAL breathing is regular, quiet, and effortless.
Without oxygen, brain cells can begin to die in 4 to 6
minutes.
Trouble breathing can be the first signal of a more serious
emergency (ie. heart problem)
BREATHING EMERGENCIES
Respiratory distress: is a condition in
which a person is having trouble breathing.
Respiratory arrest: is a condition in
which breathing has stopped.
**By recognizing respiratory distress and taking
immediate action, you can prevent respiratory arrest.
SIGNALS OF
RESPIRATORY DISTRESS
Breathing- slow or rapid, deep or shallow
Gasping for air
Wheezing sounds
Skin - flushed, pale, moist, cool, bluish
Dizziness/light-headed
Trouble speaking
Pain in chest
Tingling in hands, feet, or lips
Apprehensive or fearful feelings
CHILDREN AND RESPIRATORY
DISTRESS
Infections in the respiratory system are more
common in children and infants than in adults.
The airway, mouth and nose are smaller in
children and infants than they are in adults. As a
result - they are blocked more easily.
Signs: Agitation, drowsiness, noisy breathing,
nasal flaring, chest appears to sink with breaths,
increased heart rate, altered level of
consciousness, unusually fast/slow breathing.
Croup and Epiglottitis
Common childhood illnesses that cause
respiratory distress (common with children
under the age of 5 or 6).
Croup: is a viral infection that causes swelling
of the tissues around the vocal cords, resulting
in a harsh, repetitive cough that sounds like
the bark of a seal.
Epiglottitis: is a bacterial infection that causes
severe inflammation of the epiglottis, which
can swell and completely block the airway.
Croup Cough and Breathing Sounds
http://www.youtube.com/watch?feature=player_
embedded&v=Qbn1Zw5CTbA
CONDITIONS THAT CAUSE
RESPIRATORY DISTRESS
EMPHYSEMA- lungs lose ability to exchange
CO2 and 02 effectively.
BRONCHITIS- inflammation of the lining of the
trachea and bronchioles.
ANAPHYLACTIC SHOCK (anaphylaxis)severe allergic reaction.
HYPERVENTILATION- breathing is faster than
normal.
COPD- long term lung disease encompassing
both chronic bronchitis and emphysema.
ASTHMA- (info on next slide)
ASTHMA
Asthma: life-long lung disease in which certain substances or
conditions called ‘triggers’ cause inflammation and
constriction of the airways making breathing difficult.
Signs of attack: hoarse whistling sound when inhaling/exhaling,
rapid/shallow breathing, tightness in chest, trouble talking, etc.
Triggers: include exercise, cold air, allergens or irritants (ie.
Perfume)
3rd ranking cause of hospitalization among those younger than 15 yrs.
There are long-term and short-term meds (inhalers).
You help administer the short-term meds that will provide quick
relief and help stop the asthma attack.
Other Causes of Respiratory
Distress and Arrest
Choking (partial or complete blockage)
Illness
Electrocution
Irregular heartbeat
Heart problems
Injury to head, chest, lungs, or abdomen
Drug overdose or poisoning
CARE FOR RESPIRATORY
DISTRESS
CHECK (scene then victim)
CALL (911 or local emergency number)
CARE
Help victim rest in a comfortable position.
Check for life-threatening conditions.
Try to reassure victim and keep them calm.
Interview victim and/or bystanders especially if victim
has trouble breathing when talking.
Continue to look and listen for any changes in
breathing and level of consciousness.
Keep victim from getting chilled or overheated.
Assist in giving asthma medication if necessary.
Airway Obstructions
Will you be ready?
AIRWAY OBSTRUCTIONS
Most common cause of breathing
emergencies.
Anatomical airway obstruction- airway is
blocked by the tongue or swollen tissues of the
mouth and throat.
Mechanical airway obstruction- airway is
partially or completely blocked by a foreign
object, such as a piece of food or a small toy,
or by fluids such as vomit or blood.
AIRWAY OBSTRUCTIONS
Partial: person can still move air to and from
the lungs.
Person can cough
May be able to speak
Complete: person is choking and unable to
cough, speak, cry or breathe.
Person may be able to make high-pitched noises
May have bluish skin color
CAUSES OF CHOKING
Trying to swallow large pieces of poorly chewed
food.
Drinking alcohol before or during meals.
Wearing dentures.
Eating while talking excitedly or laughing or
eating too fast.
Walking, playing or running with food or objects
in the mouth.
Choking in Children and Infants
Choking is a common cause of injury and death in children
younger than 5 years.
Food is responsible for most choking incidents in children.
Food to keep away from children under 5 yrs old:
Hard, gooey or sticky candy
Grapes
Popcorn
Peanuts
Gum
Vitamins
Toys and small household items can also be hazardous (ie.
balloons, coins, marbles, pen caps, small toys)
Universal Choking Sign — Adult or
Child
CARE FOR AN AIRWAY
OBSTRUCTION
*A person who is getting enough air to cough
or speak also has enough air entering the lungs
to breathe.
If the person is coughing forcefully
encourage them to keep coughing.
If they continue to cough without
coughing up the object – call 911.
CARE FOR AN AIRWAY
OBSTRUCTION cont…
*If a person’s airway is completely blocked
act immediately!
You or a bystander need to call 911.
Provide 5 back blows and 5 abdominal thrusts
until the person can cough forcefully, speak,
breathe, or becomes unconscious.
Each back blow and abdominal thrust should be a
separate and distinct attempt to dislodge the obstruction.
SPECIAL CONSIDERATIONS
If a victim is obviously pregnant, is known to be pregnant,
or is too large for you to give abdominal thrusts - give
chest thrusts.
For chest thrusts – fist should be centered on the breast bone.
If you are alone, you may have to give abdominal thrusts
to yourself. This can be done by—
Leaning over a firm object and pressing your abdomen into
it.
Making a fist and giving yourself quick, upward thrusts.
For a choking person in a wheelchair, give abdominal
thrusts.
FACT TO REMEMBER
A VICTIM WILL BECOME
UNCONSCIOUS IF THE OBSTRUCTION
IS NOT REMOVED!!!
RESPIRATORY ARREST
BREATHING STOPS!!!
BODY CAN ONLY FUNCTION WITHOUT OXYGEN
FOR ONLY A FEW MINUTES BEFORE BODY
SYSTEMS BEGIN TO FAIL.
WITHOUT OXYGEN THE HEART MUSCLE STOPS
FUNCTIONING, CAUSING THE CIRCULATORY
SYSTEM TO FAIL.
BRAIN CELLS BEGIN TO DIE IN 4-6 MINUTES.
Care for Unconscious Choking Victim
If the victim becomes unconscious…
1. Carefully lower the victim to the floor.
2. Call 911 if you have not done so already.
3. Open the person’s mouth and look for an object (remove
object if present).
4. Use head-tilt/chin-lift to open airway and attempt 2 rescue
breaths.
5. Look for chest to rise and fall (if it does you know the
breaths went in - begin CPR).
6. If chest doesn’t rise/fall begin the modified CPR technique
for an unconscious choking person (Chapter 5).
Modified CPR technique for an
Unconscious Choking Victim
1. Locate the correct hand (or finger for infant) position for
2.
3.
4.
5.
6.
chest compressions.
Give chest compressions – 30 compressions (depth depends
on victim) at a rate of about 100 compressions per minute.
Look for an object: open the victim’s mouth and if you see an
object remove it with your finger (use a smaller finger for
infants).
Give 2 rescue breaths.
If the chest doesn’t clearly rise and fall, repeat steps 1-4 listed
above.
Once the air goes in – check for breathing and give care as
needed.
When can you stop performing Modified
CPR for an unconscious choking victim?
You can stop modified CPR on an unconscious victim when…
The object is removed and chest rises and falls with
rescue breaths (you may still need to perform CPR
without an object check).
The person starts to breathe on their own.
EMS or trained personnel arrives and takes over.
You are too exhausted to continue.
The scene becomes unsafe.
Goals for Breathing Emergencies
Goal: To have air reach the lungs
You must have airway open for this to
occur (head tilt – chin lift technique)
As a lay responder your role is to:
1.
2.
3.
Recognize the signals of a breathing emergency
Call 9-1-1 or the local emergency number.
Give appropriate Care.