1. Chapter Four
When Seconds Count

2. Objectives Identify five signs and symptoms of respiratory distress.
Describe the care for a person experiencing respiratory distress.
Describe the purpose of rescue breathing.
Describe when and how to provide rescue breathing for a child and infant.
Describe special considerations for rescue breathing.
Describe the care for conscious and unconscious choking for adult, child, and infant victims.
Describe what the recovery position and H.A.IN.E.S. position is and why it is used.

3. The Breathing Process
Normal breathing requires the respiratory, circulatory, nervous, and musculoskeletal systems to work together.
When you breathe air into your lungs, the oxygen in the air is transferred to the blood.
The blood transports the oxygen to the brain, other organs, muscles, and other parts of the body where it is used to provide energy.

4. The Breathing Process

5. Why time is critical… 0 minutes 4 – 6 minutes 6 – 10 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.

6. Breathing emergencies can be caused by -
An obstructed airway
Illness
Certain respiratory conditions that can inhibit breathing
Electrocution
Drowning
Heart attack
Injury to the head, chest, or lungs
Allergic reactions

7. Respiratory Distress Most common type of breathing emergency.
It is a condition in which breathing becomes difficult.
Signs & Symptoms
Slow or rapid breathing, gasping
Wheezing, gurgling, high pitched noises
Skin is moist or cool, flushed, pale, ashen, or bluish
Victim feels dizzy or lightheaded
Victim feels apprehensive or fearful

8. Care for Respiratory Distress
Call
Help the person rest in a comfortable position.
Provide fresh air.
Help maintain normal body temperature.
Calm and reassure the victim.

9. 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.

10. Universal Sign for Choking

11. 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.

12. Hand Position for Abdominal Thrusts

13. 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.

14. 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 2 rescue breaths do not go in.
When a conscious choking person becomes unconscious.

15. Care for an Unconscious Choking Adult or Child
After your initial check, when your first two rescue breaths do not go in, retilt the head and try your breaths again.
If your breaths still do not go in, you are going to perform a modified CPR technique.

16. 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
Adult – 1 ½ - 2 inches
Child – ½ 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.

17. 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
Compression depth – ½ inch to 1 inch deep
Sweep the mouth with your little finger

18. Rescue Breathing
When a child or infant stops breathing, you will have to breath for them.
You do not give rescue breathes for an adult.
If an adult is unconscious and not breathing one should assume that they are have a cardiac emergency and provide proper care.

19. Rescue Breathing - Children & Infants
After you have given two rescue breathes and determined that the victim has a pulse you begin rescue breathing.
You should give 1 rescue breath every 3 seconds.
After 2 minutes, recheck for signs of life and pulse for no more than 10 seconds to make sure the heart is still beating.

20. Rescue Breathing – Breathing Barriers
Helps protect you from contact with blood and other body fluids, as well as from breathing in the air that the person exhales.
Examples include face shields and resuscitation masks.

21. Special Situations – Rescue Breathing
Air in the stomach
This occurs when you breath too long or too hard.
Air in the lungs can cause a person to vomit, and that vomit can enter the persons lungs. This is called aspiration.
Vomiting
If the person vomits, roll them on to one side and wipe the mouth clean.
Once you have cleared away the vomit, roll the person back on to his or her back and continue rescue breathing if necessary.

22. H.A.IN.E.S. Recovery Position
Recovery Positions
Recovery Position
Used for a victim that is not suspected to have a spinal injury.
H.A.IN.E.S. Recovery Position
Used for a victim with a suspected spinal injury.