1. Breathing Emergencies Part 3: Chapter 6

2. The Basic’s 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

3. Breathing Emergencies 2 types: ▫Respiratory Distress  A condition in which breathing is difficult ▫Respiratory Arrest  A condition in which breathing stops

4. 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

5. Signs of RD Victim may…. ▫Have trouble catching their breath or grasp for air ▫Breathe faster or slower than normal

6. Victim may… ▫Breaths may become shallow or deep ▫They may make unusual noises  Wheezing, gurgling or high pitched sounds like crowing

7. Victim may… ▫Skin appearance  Unusually moist, flushed, pale ▫Temperature could drop  They may feel cool

8. Chronic conditions Asthma Narrows the air passages ▫Makes breathing difficult During an attack: ▫Passages constrict or narrow as a result of a spasm

9. Emphysema Disease in which the lungs and alveoli lose their ability to exchange CO 2 and oxygen effectively This disease worsens over time

10. 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

11. 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

12. 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

13. 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

14. Common Illnesses CroupEpiglottitis 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

15. 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)

16. 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

17. 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

18. 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)

19. 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

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

21. 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

22. 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

23. Abdominal thrusts for Child Get on their level Follow same as adult

24. Back blows for Infant 1.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

25. Chest Thrusts for Infant 1.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

26. Back blows Chest Thrust

27. 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

28. Conscious to Unconscious AdultInfant 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

29. Breathing stops Signs ▫Absence of breathing (dead give-away) ▫Skin color (ashen or cyanotic) Begin rescue breathing Respiratory Arrest

30. 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

31. 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

32. Breathing Barriers Resuscitation maskFace shield

33. 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