Breathing Emergencies

What are the parts?

• Nose• Mouth• Tongue• Epiglottis• Trachea

Remember…If you do nothing else

Normal Breathing• Quiet and Effortless• No sign of discomfort or struggle• Not too slow or too fast• Children and Infants: Breathing is faster

Respiratory Distress• Breathing is difficult, but still occurring• If left untreated, may lead to Arrest

Causes of Respiratory Distress & Arrest

• Choking• Illness• Chronic Conditions – Asthma• Electrocution• Irregular Heartbeat• Heart Attack• Injury – Head, Neck, Chest, Lungs, Abdomen• Allergic Reaction• Drugs & Alcohol - Overdose

Causes of Respiratory Distress & Arrest

• Poisoning• Emotional Distress• Drowning

Asthma

Inflammation of the air passages resulting in a temporary narrowing of the airways.

• Can be sudden onset – cold air, allergens, etc.• Usually hear wheezing, or whistling sound• People with diagnosed condition - Inhaler

COPD

Chronic – long term lung disease – chronic bronchitis and emphysema.

• Excessive cough – lots of mucus• Tire easily• Fast Pulse• Round, Barrel-shaped chest• Confusion

COPD

Emphysema – damage to the air sacs in the lungs

• Typically found in smokers – middle to older age

• Shortness of breath – very difficult to exhale

COPD

Bronchitis – inflammation of the main air passages – acute / chronic.

• Chest discomfort• Fatigue – Excessive coughing• Shortness of breath – worse with activity• Swelling of ankles and feet – fluid retention• Frequent respiratory infections / colds

Hyperventilation

Faster than normal breathing, shallow breaths – reduces the oxygen intake

• Emotional factors – stress / anxiety• Can be caused by injury, illness, etc.• Body increases the respiration rate• Less oxygen, more CO2 in body

Allergic Reactions

Response of the body’s immune system to a foreign substance – environmental, food, meds

• Tightness in chest• Swelling of body parts – especially airway• Severe reactions can cause swelling to the

point of cutting off air supply

What to look forYou don’t need to be overly concerned with why, just what:

1. Trouble breathing or not breathing2. Slow / Rapid rate3. Gasping4. Wheezing, Gurgling5. Moist / Cool skin6. Bluish lips / skin / nail beds7. Chest pain

What to do while you waitCall 911 IMMEDIATELY – Or the wait is much longer

1. Help the person find a comfortable position, usually sitting up, laying down can make it worse

2. If conscious – check for other conditions3. Try to reassure to calm anxiety4. Question bystanders – if they know the person,

what were they doing, etc.5. Hyperventilating – Reassure, talk calmly, monitor

their condition closely.

What to do while you waitCall 911 IMMEDIATELY – Or the wait is much longer

1. Un-conscious adult? – Most likely cardiac – begin CPR immediately (We’ll cover this later)

2. If you know it is respiratory related – drowning, drug overdose, etc. – 2 Rescue Breaths, quick scan for bleeding, then CPR

3. For children and infants – 2 Rescue Breaths, quick scan for bleeding, then CPR

ChokingCommon breathing emergency – especially in young children and infants

Causes:

1. Poorly chewed food2. Alcohol overdose (especially during meals – dulls the

nerves that aid in swallowing)3. Dentures4. Eating while talking, laughing, etc.5. Walking / playing with food or objects in the mouth

Choking in Children & InfantsEverything goes in the mouth – EVERYTHING

Most common foods kids choke on:

1. Hot dogs2. Grapes3. Popcorn4. Gooey, Sticky, hard candy5. Vitamins6. Chewing Gum

Choking in Children & InfantsEverything goes in the mouth – EVERYTHING

Most common non-food items kids choke on:

1. Baby Powder2. Trash Contents3. Safety Pins4. Coins5. Marbles6. Pen / Marker Lids7. Button Batteries

What to look forSigns of choking:

1. Coughing2. Clutching throat – Universal sign3. Inability to cough or speak4. High-Pitched noisy breathing5. Panic6. Blue skin7. Losing consciousness

Universal sign for choking

What to do while you waitCall 911 IMMEDIATELY – Or the wait is much longer

1. If coughing – encourage them to keep coughing2. If no air movement – but conscious get consent3. Begin Backblows / Abdominal Thrusts – 5:5

Backblows & Abdominal Thrusts

Backblows & Abdominal Thrusts

What about “Fluffy” People?

How long?Continue alternating between back blows and abdominal thrusts until:

1. The object is free and the person is no longer choking

2. The person loses consciousness

Conscious choking infant

Conscious choking infant

Adult / Child – Now they’re unconscious

• Lower them to the ground – gently• Face up• Open the mouth and look, sweep out a

foreign object if you see one – no probing!• Head Tilt / Chin Lift – 2 Rescue Breaths• If they don’t go in, reposition the head and try

again

Adult / Child – Now they’re unconscious

• Still didn’t go in, give 30 chest compressions• Open the mouth, look and sweep if you see it• Try 2 rescue breaths again• Didn’t go in, reposition, and try again• Didn’t go in – continue chest compressions

How long?Continue this cycle until:

1. The object comes out and the chest clearly rises with each rescue breath

2. The person begins to breathe on their own3. Someone trained equally or higher arrives and

takes over4. You become too exhausted to continue5. Scene becomes unsafe

Unconscious InfantLay the infant on a firm flat surface – counter top or table are best

1. Immediately begin 30 chest compressions2. Open airway and look, remove if you see it, if not:3. Try 2 rescue breaths, if they don’t go in, reposition

and try again4. Still won’t begin another cycle of compressions

Let’s practice1. Get into groups of 32. Victim, Rescuer, Bystander3. Practice conscious choking adult / child4. Rotate after 2 cycles of Back Blows and Abdominal

Thrusts

Skill sheets for this practical are on the website:

www.dereksplace.org

Questions?

I have ADD…I don’t remember what was on the second slide

www.dereksplace.org