breathing emergencies

BREATHING

EMERGENCIES

ABCD’s

• AIRWAY

• BREATHING• CIRCULATION

• DEFIBRILLATION

• SEVERE BLEEDING

The Breathing Process• Air (oxygen) into nose and

mouth---passes through pharynx----travels through the trachea--- lungs---blood---delivered to brain, organs, muscles (provides energy)

BRAIN and OXYGEN

• Brain is very sensitive to oxygen starvation

• Brain cells start to die in 4-6 minutes without oxygen

TIME FRAME• 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

BREATHING• Brain controls breathing

• Adjusts rate and depth of breaths based on O2 and CO2 levels

• Requires respiratory, circulatory, nervous, and musculoskeletal systems to work together

BREATHING EMERGENCIES• An obstructed airway (choking)• Illness, such as pneumonia• Respiratory conditions (asthma, emphysema)• Electrocution• Shock• Drowning• Heart attack or heart disease• Chest or lung injury• Allergic reactions (food, insects)• Drugs• Poisoning• Hyperventilation

RESPIRATORY DISTRESS

• Most common type of breathing emergency

• Injury

• Illness

• Excitement

• Anxiety

SIGNS and SYMPTOMS--RD

• Obvious

• Cannot catch their breath or gasp for air

• Grunting, wheezing, gurgling, shrill sounds

• Breaths unusually fast, slow, deep, or shallow

• (slow= less than 8 breaths per minute)

S/S Respiratory Distress

• Skin

• Unusually moist and flushed

• Pale, ashen, or bluish (cyanosis)

• Symptoms

– Dizzy, lightheaded, painful, tingling in lips, hands, or feet

Specific Types of RD

• Asthma

• Emphysema

• Hyperventilation

• Anaphylaxis

Care for RD• Initial assessment• Summon EMS• Help the victim rest comfortably• Physical exam• SAMPLE history• Reassure the victim• Assist with medication• Monitor vital signs

RESPIRATORY ARREST

• Breathing stops

–Illness

–Injury

–Obstructed airway

*heart will stop beating, organs will begin to fail

RESCUE BREATHING

• Breathing air into a person to supply him or her with the O2 needed to survive

STEPS

• Determine LOC—unresponsive

• Open airway and look, listen, feel for breathing

• No breathing

–Give 2 slow breaths

–Check for pulse

–Look for severe bleeding

RESCUE BREATHING

• Keep airway open

• 1 breath every 5 seconds

• Every minute re-check pulse

When to stop rescue breathing:• Victim breathes on own

• Victim has no pulse—CPR

• Someone with more training than you arrives

• You are too exhausted to continue

• The scene becomes unsafe

Special considerations:

• Air in stomach

• Vomiting

• Mouth-to-nose breathing

• Mouth-to-stoma breathing

• Victims with dentures

• Suspected spine injury

Infants and Children• Faster breath rate and pulse rate

than adults• Rescue breaths are faster• Less air in each breath• Head-tilt is less• Cover mouth and nose

• Infants: 1 breath every 3 seconds• Children: 1 breath every 5 seconds

AIRWAY OBSTRUCTIONS

• Most common cause of respiratory emergency

• TWO causes: anatomical or mechanical

• Partial or Complete

PARTIAL AIRWAY OBSTRUCTION• Can still move some air in and out

of the lungs• Person can still cough and/or speak• Person may clutch throat (universal

sign)

• Encourage them to keep coughing and summon EMS if it continues

COMPLETE AIRWAY OBSTRUCTION• Unable to speak, cough, cry,

or breathe

• CALL 911

• Heimlich Maneuver/ Abdominal thrusts until the obstruction is clear (or they become unconscious)

Unconscious Choking Adult/Child• Lay the person down1. Open the airway by lifting the jaw

up2. Finger sweep3. Open the airway—head-tilt/chin-lift4. Give 2 slow breathsIf air does not go in:5. Reposition (retilt) the head6. Give 2 slow breaths

If air still does not go in:

7. Give up to 5 abdominal thrusts or chest thrusts**

8. Do a finger sweep

9. Give 2 slow breaths (reposition if necessary)

Repeat until object is expelled

Chest Thrusts

• Middle of the sternum

• Person is too large or they are pregnant

• Compress 1 ½ to 2 inches

• 5 quick thrusts

Conscious Choking Infant• Call 911

• Alternate 5 back blows and 5 chest thrusts until the object comes out

Unconscious Choking Infant

1. 2 slow breaths (they don’t go in)2. Reposition head3. 2 more slow breaths (if they don’t go in,

assume airway is obstructed)4. Give 5 back blows5. Give 5 chest thrusts6. Do a foreign body check7. Open the airway8. Give 2 slow breaths (if they don’t go in,

repeat steps)