Chapter Four

Breathing Emergencies

Why time is critical…

0 minutes Breathing stops. Heart will

soon stop beating. 4 – 6 minutes

Brain damage possible. 6 – 10 minutes

Brain damage likely. Over 10 minutes

Irreversible brain damage certain.

Distress vs. Arrest

Respiratory distress – a condition in which breathing becomes difficult

Respiratory arrest – occurs when breathing stops

Normal breathing is regular, quiet and effortless. A person does not appear to be working hard or struggling.

Signs and Symptoms of Respiratory Distress Slow or rapid breathing

Gasping Wheezing, high pitched noises Gurgling Skin is moist or cool, flushed, pale, ashen, or

bluish Victim feels dizzy or lightheaded Victim feels apprehensive or fearful

Normal Breathing in Children and Infants Normal breathing rates in children and infants

are faster than normal breathing rates in adults.

Infants have periodic breathing, changes in breathing patterns are normal for infants.

Breathing emergencies can be caused by - Choking Illness Chronic conditions, such as asthma Electrocution Heart attack or irregular heartbeat Injury to the head, chest, or lungs Allergic reactions Drug overdose Drowning Emotional distress

Asthma

Inflammation of the air passages that results in temporary narrowing of the airways.

Asthma is the third ranking cause of hospitalization among those younger than 15 years.

Asthma attacks are often recognoized by the wheezing or whistling sound that is made when exhaling.

Chronic Obstructive Pulmonary Disease COPD is a long term lung disease

encompassing both chronic bronchitis and emphysema.

Airways become partly blocked and the air sacs in the lungs lose their ability to fill with air.

There is no cure and it worsens over time. The most common cause of COPD is

smoking.

Emphysema & Bronchitis

Emphysema is a disease that involves damage to the air sacs. Exhaling is extremely difficult.

Bronchitis is an inflammation of the main air passages. To be diagnosed with chronic bronchitis, a person must have a cough with mucus on most days of the month for at least 3 months.

Hyperventilation

Occurs when a person’s breathing is faster and more shallow than normal.

Often results from fear or anxiety and usually occurs in people who are tense and nervous.

Also caused by- Head injuries Severe bleeding Asthma Exercise

Allergic Reactions An allergic reaction is the response of the

immune system to a foreign substance that enters the body.

A severe allergic reaction can cause a condition called anaphylactic shock.

Signals include – Rash Tightness of chest and throat Swelling of face, neck and tongue Person may feel dizzy or confused

Croup

A harsh, repetitive cough that most commonly affects children younger than 5 years.

Cough can range from high pitched wheeze to a barking cough.

Croup mostly occurs during the evening or nighttime.

Epiglottitis

Infection causing severe swelling of the epiglottis.

When it swells it can block the airway. Most common in children between 2 and 6

years of age. Hib vaccine has helped decrease the number

of cases.

Care for Respiratory Distress Call 9-1-1. Help the person rest in a comfortable

position. If the person is having a hard time talking

have them nod or shake their head to answer questions.

If a bystander is present and can answer questions about the victim, ask the bystander instead.

Try to calm the victim.

Choking

Choking occurs when a person’s airway has been blocked by a foreign object, swelling in the mouth or throat, or by fluids such as vomit or water.

Causes of Choking in Adults

Trying to swallow large pieces of poorly chewed food

Drinking alcohol before or during meals Wearing dentures Eating while talking excitedly or laughing Eating too fast Walking, playing or running with food or

objects in the mouth

Choking in Children & Infants

Common cause of injury and death in children younger than 5 years.

Children should not be given hard, smooth foods such as raw vegetables until they are 4 years old. No peanuts until 7 years or older.

Food should be chopped into pieces no larger than ½ inch.

Signals of choking -

Coughing, either forcefully or weakly Clutching the throat Can’t cough, speak, cry or breathe High pitched noises Panic Bluish skin color Loss of consciousness

Care for a Conscious Choking Adult or Child Give five back blows and five abdominal

thrusts until the object is dislodged and the person can breathe or becomes unconscious.

Hand Position for Abdominal Thrusts

Care for a Conscious Choking Infant Give five back blows and five chest thrusts

until the object is forced out, the infant begins to breathe on his or her own or the infant becomes unconscious.

Care for an Unconscious Choking

Adult or Child This care would be given –

During your check for life threatening conditions, when an unconscious person is not breathing and the rescue breaths do not go in.

When a conscious choking person becomes unconscious.

Care for an Unconscious Choking

Adult or Child After your initial check, when your first two rescue breaths do not go in, re-tilt the head and try another breath again.

If your breaths still do not go in, you are going to perform a modified CPR technique.

Care for an Unconscious Choking

Adult or Child Locate the correct hand position. Compress the victim’s chest 30 times in about 18 seconds.

Chest compression depth – 2 inches Look for a foreign object, if you see an object, sweep it out. Give 2 rescue breaths. If your breaths do not go in, repeat chest compressions until –

The object is removed and the chest rises with rescue breaths. The person starts to breath on their own. Another trained responder arrives. You are too exhausted to continue. The scene becomes unsafe.

Care for an Unconscious Choking Infant There are some minor changes when

providing care for an infant – Hand position – two fingers in the middle of the

chest, top hand on the forhead keeping the airway open

Compression depth – 1 ½ inches Sweep the mouth with your little finger