1. Ch. 17-Respiratory Emergencies

2. 17.1 Dyspnea
1. Maintain an open airway. Dyspnea may be caused by aspiration of a foreign body, so consider aspiration and clear the airway if necessary.
2. Ventilate or provide assisted ventilations if necessary.
3. If the victim is breathing adequately, place in a position of comfort. 2

3. PROGRESS CHECK 1. Dyspnea is defined as ____________.
(labored breathing/air hunger/shortness of breath)
2. Victims of dyspnea may be breathing rapidly or slowly, but always feel ____________. (dizzy/short of breath/faint)
3. Dyspnea is not a ____________, but is a symptom of a number of diseases. (disease itself/medical emergency/respiratory syndrome)
4. Because dyspnea can be caused by ___________, always check the airway. (aspiration/internal bleeding/bronchitis) 3

4. 17.2 Chronic Obstructive Pulmonary Disease
Emphysema (Pink Puffers)
Evidence of weight loss
History of increasing dyspnea on exertion
Progressive limitation of activity
Production of only small amounts of mucus with coughing
Chronic Bronchitis (Blue Bloaters)
Coughing that produces thick mucus
Use of neck and chest muscles to assist breathing
Cyanosis
Swelling of the hands, feet, and ankles
Distended neck veins
High-pitched wheezing during both inhalation and exhalation
Low-pitched snoring sounds during both inhalation and exhalation 4

5. Vocabulary Dyspnea- Shortness of breath or difficulty in breathing
Chronic obstructive pulmonary disease- A range of diseases including emphysema, chronic bronchitis, and asthma
Emphysema- A respiratory disease characterized by overinflated alveoli
Pink puffer- A victim of emphysema
Blue bloater- A victim of chronic bronchitis 5

6. First Aid Care for COPD 1. Establish an airway.
2. Help the victim into the most comfortable position —usually sitting or semisitting.
3. If the victim is unconscious, administer artificial ventilation if necessary.
4. Monitor the victim’s respiratory rate and depth, and assist ventilations if respiration becomes depressed. Watch the victim closely for changes in rate and depth.
5. Maintain the victim’s body temperature.
6. Loosen restrictive clothing, comfort and reassure the victim, and encourage the victim to cough up secretions. 6

7. PROGRESS CHECK
1. Victims of emphysema are sometimes called ____________. (blue bloaters/pink puffers)
2. The condition in which repeated infections thicken and distort the lining of the bronchial tree is ____________.
(emphysema/chronic bronchitis/status asthmaticus)
3. Because the walls of the alveoli have broken down in victims of emphysema, air is ____________ in the lungs. (trapped/concentrated/leaking)
4. The number-one goal of care for COPD is to ____________. (prevent aspiration/enhance oxygenation/assist ventilation) 7

8. 17.3 Asthma
Two Degrees:
1. Acute asthma, consisting of periodic attacks and symptom-free periods between attacks
2. Status asthmaticus, consisting of a prolonged and life-threatening attack 8

9. 9

10. First Aid Care
1. Establish an airway and assist ventilations if necessary.
2. Stay calm and keep the victim as calm as possible; stress and emotional intensity worsen the asthma attack. Keep the victim in a position of comfort, usually sitting up.
3. If you are allowed to do so in your area, help the victim use any asthma medication he or she may have (often an inhaler). 10

11. Vocabulary Bronchospasm- Generalized spasm of the bronchi
Status asthmaticus- A severe, prolonged asthma attack that represents a dire medical emergency
Hyperventilation- A condition characterized
by overbreathing or breathing too rapidly
Hyperventilation syndrome- An abnormal
state in which rapid breathing persists
Carpopedal spasm- Drawing up of the hands at the wrists and knuckles with flexed fingers 11

12. PROGRESS CHECK
1. The main physiological event in asthma is ____________ of the airway.
(obstruction/narrowing/complete blockage)
2. A prolonged, life-threatening asthma attack is called ____________.
(acute asthma/bronchial asthma/status asthmaticus)
3. There are two different kinds of asthma––one most often caused by infection or emotion and the other most often caused by ____________.
(allergy/aspirin/cold air)
4. In a typical attack, the victim’s cough is ____________.
(productive/unproductive/intermittent)
5. The three goals of first aid care for asthma are to improve oxygenation, relieve bronchospasm, and improve ____________.
(circulation/metabolism/ventilation)
6. Status asthmaticus is usually characterized by ____________.
(severe wheezing/low-pitched snoring/absent breath
sounds) 12

13. 17.4 Pneumonia Signs and Symptoms First Aid Care
Chest pain, usually worse when breathing
Dyspnea
Rapid respiration
Respiratory distress
Noisy breathing
Productive cough
First Aid Care
1. Place the victim in a position of comfort that enables the victim to breathe with the least distress; most prefer an upright or semisitting position.
2. Maintain an open airway.
3. Transport the victim to a physician. 13

14. PROGRESS CHECK
1. Pneumonia describes a group of illnesses characterized by __________.
(fever and chills/productive cough/lung inflammation)
2. Pneumonia is most often caused by __________.
(infection/immune suppression/injury)
3. A characteristic sign of pneumonia is __________.
(wheezing/fatigue/fever and chills) 14

15. 17.5 Hyperventilation Signs and Symptoms
Marked anxiety, leading to panic
Air hunger
Giddiness or unusual behavior
Fatigue
Abdominal discomfort or bloating
Drawing up of the hands at the wrists and knuckles with flexed fingers (carpopedal spasm)
Dyspnea
Dizziness or light-headedness
Blurring of vision
Dryness or bitter taste in the mouth
Numbness and/or tingling of the hands and feel or the area around the mouth
Tightness or a “lump” in the throat
Pounding of the heart with stabbing pains in the chest
Great weakness
A feeling of impending doom
Fainting
Deep, sighing, rapid respirations with a rapid pulse 15

16. 17.5 Hyperventilation First Aid Care 1. Remain calm and reassuring
2. Try to talk the victim into slowing the breathing rate.
3. Explain to the victim what happened, and reassure the victim that it is not serious.
4. Transport the victim to an emergency room or activate the EMS system. 16

17. PROGRESS CHECK
1. Hyperventilation syndrome is an abnormal state in which rapid breathing ____________.
(occurs periodically/comes in cycles/persists)
2. Hyperventilation is fairly benign unless caused by ____________.
(anxiety/severe fright/an underlying medical condition)
3. Hyperventilation is characterized by __________ during breathing. (deep sighs/wheezing/rales)
4. To care for hyperventilation not caused by a medical condition, ____________. (have the victim breathe into a paper bag/calm the victim/give artificial ventilation) 17