Breathing EmergenciesPart 3: Chapter 6

What is breathing?• This is the

process which oxygen is transferred into your blood• The oxygen is

then carried throughout your body• Without oxygen

the body would shut down and cease to work

Breathing Emergencies

•2 types:▫Respiratory Distress

A condition in which breathing is difficult▫Respiratory Arrest

A condition in which breathing stops

Respiratory Distress (RD)

• Most common:▫ Partially blocked

airway ▫ Illness▫ Chronic conditions

Emphysema Asthma

▫ Electrocution ▫ Heart attacks▫ Injury (head, lungs

or abdomen)▫ Allegoric Reactions▫ Drugs Poisoning▫ Emotional distress

Signs of RD

•Victim may….▫Have trouble catching their breath or grasp

for air▫Breathe faster or slower than normal

Victim may…

▫Breaths may become shallow or deep

▫They may make unusual noises Wheezing, gurgling or high pitched sounds like crowing

Victim may…

▫Skin appearance Unusually moist, flushed, pale

▫Temperature could drop They may feel cool

Chronic conditionsAsthma

•Narrows the air passages▫Makes

breathing difficult

•During an attack:▫Passages

constrict or narrow as a result of a spasm

Emphysema

•Disease in which the lungs and alveoli lose their ability to exchange CO2 and oxygen effectively

•This disease worsens over time

More Conditions• Bronchitis

▫Caused from smoking and other irritants▫Results from an inflammation of the lining of the

trachea, bronchi and bronchioles▫This cause a build up of mucus which obstructs air

exchange in the lungs• Anaphylactic Shock

▫Caused from a severe allergic reaction Bee sting, foods, other allergens or certain

medications▫Air passages swell and restricts victims breathing▫Could be life-threatening if not treated

immediately

More Conditions

•Hyperventilation▫Can results from fear or anxiety▫May be caused by head injuries, severe

bleeding or illnesses such as high fever, heart failure, lung disease or diabetic emergency

▫Likely to occur in people who are tense and nervous

▫A person may feel like they are suffocating Some become fearful and apprehensive

Care for a RD• Check

▫ The scene to ensure of your safety▫ If the victim is conscious▫ Check for other life-threatening causes

• Call▫ 9-1-1

• Care▫ Help the victim rest in a comfortable position▫ Loosen any tight clothing (necktie etc)▫ Open a door or window for fresh air▫ Interview the victim▫ Continue to monitor and reassure the victim▫ Assist them in any way possible

Special Considerations (Children)•Signals

▫Agitation▫Unusually fast or slow breathing▫Drowsiness▫Noisy breathing▫Pale, ashen, flushed or bluish skin color▫Breathing trouble increases▫Altered level of consciousness▫Increased heart rate

Common IllnessesCroup Epiglottitis

• Viral infection• Causes swelling of the

tissues around the vocal cords

• Often preceded by 1-2 days of illness, sometimes a fever

• Cough that sounds like the bark of a seal

• Bacterial infection • Causes a severe

inflammation of the epiglottis

• When this swells it can completely block the airway

• The child will appear ill and have a high fever with a sore throat

• Often the child will be sitting up straining to breath

• Child may be drooling more than usual

Airway Obstruction – Conscious Victim•Airway obstruction (Most Common)

▫2 types: Anatomical – airway is blocked by the

tongue or swollen tissue of the mouth or throat. May have resulted from an injury to the neck or

from anaphylaxis Mechanical – airway is partially or

completely blocked by a foreign object (piece of food or small toy, or by fluid such as vomit or blood)

Some common causes of Airway Obstruction

•Trying to swallow large pieces of poorly chewed food

•Drinking alcohol before or during meals.▫Alcohol dulls the

nerves that aid swallowing, making choking on food more likely

Some common causes cont…

•Wearing dentures▫Dentures make it difficult

for a wearer to sense whether food is fully chewed before swallowing

•Eating while talking excitedly or laughing or eating too fast

•Walking, playing or running with food or objects in the mouth

Partial Airway Obstruction

•These victims can still move air to and from their lungs

•Encourage the victim to cough. This may help dislodge the blockage

•*If coughing does not improve or gets worse take action(see complete airway obstruction)

Complete Airway Obstruction

•When an object is completely blocking the flow of air into the lungs

•Give 5 back blows followed by 5 abdominal thrust

Hand position:- Place the thumbs against the middle of the victims abdomen , just above the navel and well below the breastbone

What do You do???

•Choking alone▫2 techniques for abdominal thrusts

Make a fist with 1 hand, and place the thumb side on the middle of your abdomen slightly above your navel and below your breastbone. Grasp your fist with your other hand and give quick, upward thrusts

Use a chair, railing or a sink to help give you thrusts

Abdominal Thrusts for Adult• Hand Position- Below the breastbone and above the

navel• 5back blows, 5 abdominal thrusts• If alone- use chair, railing, or sink to help with

thrusts

Abdominal thrusts for Child

•Get on their level•Follow same as adult

Back blows for Infant1. Sandwich the infant between your forearms.

Support the infants head and neck by holding the jaw between your thumb and forefingers

2. Turn the infant over so that it’s facedown in your forearm. Give 5 firm back blows with the heel of your hand while supporting the arm that is holding the infant on your thigh

Chest Thrusts for Infant1. Chest thrusts:

1. Sandwich the infant between your forearm . Continue to support the infants head. Turn the infant onto it’s back and support your arm on your thigh. The infants head should be lower than the chest

2. Give 5 chest thrust

Back blows Chest Thrust

Conscious Infant

•Look to see what they are choking on•They can easily swallow small objects

which can block their airway▫Pennies, beads, parts of toys

•Make sure to follow proper support techniques

Conscious to Unconscious

Adult Infant

• Once the victim has become unconscious bring them to the floor

• 2 rescue breaths▫ Check to see if the

breathes went in by checking if the chest raised

• If they did not go in give 30 chest compressions

• Lay the child down • 2 rescue breaths

▫ Watch the chest to see if they went in

• If they did not go in give 30 chest compressions

• Check to see if the object is now visible ▫ Finger sweep the object

out• If not continue with 2 rescue

breaths and compression sequence

•Breathing stops•Signs

▫Absence of breathing (dead give-away)▫Skin color (ashen or cyanotic)

•Begin rescue breathing

Respiratory Arrest

Rescue Breathing for a Child

•Use less air than you would with an adult•DO NOT tilt head and chin back only far

enough to get the air in•1 breath every 3 seconds

▫Each breath should only last 1 second

Rescue Breathing for an Infant

•Cover both the nose and mouth with your mouth

•1 breath every 3 seconds•Each breath should last about 1 second•Breath only until you see the chest rise•DO NOT over-inflate the lungs•Recheck for signs of life ~2 minutes

Breathing BarriersResuscitation mask Face shield

When to Stop

•The scene becomes unsafe•The victim begins to breathe in his or her

own•Another trained person takes over for you•EMS personnel arrive on the scene and

take over•You are too exhausted to continue