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Chapter 6 Breathing

Emergencies
Introduction

The body requires a constant supply of oxygen
for survival
When you breathe air into your lungs, the
oxygen in the air is transferred to the blood
Without oxygen, brain cells can begin to die in
4 to 6 minutes
If someone is having trouble breathing or has
stopped breathing, you should follow the
emergency action steps: CHECK — CALL —
CARE
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Breathing Emergencies

There are two types of breathing
emergencies:
 Respiratory distress
 Respiratory arrest
Both conditions are life threatening

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Respiratory Distress
Respiratory distress is a condition in which
breathing becomes difficult
Partially obstructed airway
Illness (Bronchitis)
Emphysema or asthma
Electrocution
Heart Attack
Injury
Allergic Reactions
Emotional distress
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Asthma

• Asthma is a condition that narrows the
air passages and makes breathing
more difficult
• The characteristic sign of asthma is
wheezing when exhaling

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Emphysema

Emphysema is a disease in which the
lungs lose their ability to exchange
carbon dioxide & oxygen effectively
Signals include:
 Shortness of breath
 Restlessness
 Confusion
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 Weakness
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Bronchitis

• Bronchitis is a condition resulting in
inflammation of the lining of the
trachea, bronchi and bronchioles
• The inflammation causes a build-up of
mucus that obstructs air passages

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Bronchitis
(continued)

Signals include:
 Persistent cough
 Tightness in the chest
 Trouble breathing
As with emphysema, the victim
may also feel restless, confused
and weak
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Anaphylactic Shock

(Anaphylaxis)
Anaphylactic shock, also known as
anaphylaxis, is a severe allergic reaction
Signals include:
Skin rash
Tightness in the chest and throat
Swelling of the face, neck and tongue
Dizziness or confusion
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Hyperventilation

Hyperventilation is a condition that occurs
when someone breathes faster than normal
Signals include:
Deep, rapid breathing
Fear, apprehension, confusion or
dizziness
Fingers, toes or lips feel numb or tingly
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Respiratory Arrest
Respiratory arrest occurs when
breathing stops
Signals:
Absence of Breathing
Skin Color (ashen or cyanotic)
By recognizing respiratory distress
and taking immediate action, you
may prevent respiratory arrest
Care for Respiratory
Distress
CHECK the scene
CHECK the victim
CALL 9-1-1 or the local emergency
number
CARE for conditions you find:
 Loosen any tight clothing
 Provide fresh air
 Make sure someone has called 9-1-1 or the
local emergency number
 Check for other life-threatening conditions and
monitor ABCs
 Interview the victim and any bystanders
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Children & Respiratory Distress
Infections of the respiratory system are more
common in children and infants than adults
Signals of respiratory distress in children include:

 Agitation
 Unusually fast or slow breathing
 Drowsiness
 Noisy breathing
 Pale, ashen, flushed or bluish skin color
 Increased breathing trouble
 Altered level of consciousness
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Children & Respiratory Distress (continued)

Common childhood illnesses that cause respiratory
distress include croup and epiglottitis
Croup is a viral infection that causes swelling of the
tissues around the vocal cords, resulting in a cough
that sounds like the bark of a seal
Epiglottitis is a bacterial infection that causes severe
inflammation of the epiglottis, which can swell and
completely block the airway
Signals of epiglottitis include:
 Rapid onset of a high fever
 Sore throat and drooling from the mouth
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CROSS of the epiglottis that prevents the child from
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Children & Respiratory Distress
(continued)

Care for a child in respiratory distress includes:
 Allowing him or her to remain in the most comfortable
position for breathing
 Calling 9-1-1 or the local emergency number if the
child’s breathing does not appear to improve or at the
first signal that the child’s condition is worsening
 Not attempting to place any object in the child’s mouth
A child with a blocked airway has a life-threatening
emergency

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Choking
Introduction
Airway obstruction is the most common
respiratory emergency
There are two types of airway obstruction:
 Anatomical
 Mechanical
An anatomical airway obstruction occurs if the
airway is blocked by the tongue or swollen
tissues of the mouth or throat
A mechanical airway obstruction occurs if the
airway is blocked by a foreign object

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Causes & Signals of Conscious
Choking: Adult or Child

Common causes of choking include:
 Trying to swallow large pieces of poorly chewed
food
 Wearing dentures
 Eating while talking or laughing, or eating too fast
 Walking, playing or running with food or objects in
the mouth

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Causes & Signals of Conscious
Choking: Infant

An infant can easily swallow small
objects or small pieces of food which
can then block the airway
Additional reasons for choking
include:
 The infant’s airway has not fully developed
 Infants are still developing eating skills

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Conscious Choking: Adult or Child

The universal signal of choking

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Partial Obstruction
If air can still move to & from the lungs:
Cough
Speak
Weezing
Encourage them to keep coughing &
stay calm
Complete Obstruction
Care for Conscious Choking:
Adult or Child
If a person cannot cough, speak or
breathe, assume the airway is obstructed
A combination of 5 back blows followed
by 5 abdominal thrusts is an effective way
to clear an airway obstruction

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Complete Obstruction:
Conscious Choking Infant

If an infant cannot cough, cry
or breathe, assume the airway
is obstructed and perform 5
back blows followed by 5 chest
thrusts

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Special Considerations
When a conscious choking infant becomes
unconscious:
 Lower the infant to a table or floor
 Call 9-1-1 or the local emergency number
 Attempt 2 rescue breaths. If the breaths do not go in,
reposition the airway and give breaths again
 Continue the sequence of giving 30 chest
compressions, removing an object if you see it, then
providing 2 rescue breaths, until you are able to get air
in or EMS personnel arrive and take over

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Special Considerations
If a victim is obviously pregnant or is known to
be pregnant or too large for you to give
abdominal thrusts, give chest thrusts.
If you are alone, you may have to give
abdominal thrusts to yourself. This can be
done by:
 Leaning over a firm object and pressing your
abdomen into it
 Making a fist and giving yourself quick, upward
thrusts
 Impaling yourself
Help a conscious choking adult or child who
becomes unconscious to the floor. Call 9-1-1 or
the local emergency number and give care.

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Rescue
Breathing—Child
Introduction

Respiratory arrest is a life-threatening
condition in which breathing stops
It is commonly caused by injury, illness or
choking
If uncared for, respiratory arrest can lead to
cardiac arrest
Body systems will progressively fail during
respiratory arrest
You can keep the child’s respiratory system
functioning artificially by giving rescue
breathing
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Rescue Breathing
Rescue breathing is a way of breathing
air into a child’s lungs to supply the
oxygen he or she needs to survive
Rescue breathing is given a child who is
not breathing but still has a pulse
Each breath should last about 1 second
long
1 rescue breath/ 3 seconds

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Breathing Barriers
A resuscitation mask or face shield
(also known as a CPR breathing
barrier) may reduce the risk of disease
transmission between the responder
and the victim

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Mouth to nose Breathing
If you can not make adequate seal
If jaw is too injured:
Maintain head-tilt position
Close mouth
Seal around nose and breathe
Open between breaths to help let air out
Mouth to Stoma Breathing
Some people have all of their upper airway
surgically removed. They breathe through a
stoma instead
Stoma is a small opening in front of the neck
Can be obscured by clothing
Look listen and feel over Stoma
Give breaths at stoma like mouth-to-mouth
Remove mouth between breaths to let air out
Special Considerations for
Rescue Breathing
If dentures are worn only remove them if they
block the airway or makes it difficult for you to
give your breaths
Rescue breathing is a simple skill to perform;
however if air gets in the stomach it may
require special attention
Gastric distention may cause a child to vomit
 Keep breaths about − 1 second
 Keep the child’s head tilted correctly for his or her age
or size
 Breathe into the child, only enough to make the chest
clearly rise
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Rescue Breathing—Infant
Introduction

Respiratory arrest is a life-threatening
condition in which breathing stops
This condition is commonly caused by illness,
injury or choking
Respiratory arrest, if uncared for, can lead to
cardiac arrest
Body systems will progressively fail during
respiratory arrest
You can keep the infant’s respiratory system
functioning by giving rescue breathing

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Rescue Breathing
Rescue breathing is a way of supplying
oxygen to a non-breathing infant by
breathing air into the lungs
Rescue breathing is given to infants who
are not breathing but have a pulse
Each breath should last about 1 second
1 rescue breath/ 3 seconds

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Breathing Barriers
A resuscitation mask or face
shield (also known as a CPR
breathing barrier) may reduce the
risk of disease transmission

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Special Considerations for
Rescue Breathing

Rescue breathing is a simple skill
to perform; however, several
situations may require special
attention:
 Air in the stomach
 Vomiting

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When to Stop**
The scene becomes unsafe
Victim begins to breathe
Another trained person takes over
EMS arrive on the scene and take over
You are too exhausted to continue
Vomiting
If the victim vomits while giving rescue
breaths:
Roll them onto their side (recovery position)
Avoid twisting the neck & back
Wipe mouth clean
Reposition on back
Reopen airway
Continue rescue breaths
Closing Breathing
Emergencies
Breathing emergencies are life-threatening
conditions
There are two types of breathing emergencies:
 Respiratory distress
 Respiratory arrest
Specific causes of “breathing emergencies”
include asthma, emphysema, bronchitis,
hyperventilation and anaphylactic shock
By recognizing respiratory distress and taking
action, you may prevent respiratory arrest

Questions?
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Closing: Choking Adult/Child

The primary way to correct an airway
obstruction for a conscious adult or child is
to use cycles of back blows and abdominal
thrusts
Correct Count?

Questions?
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Closing: Choking Infant
Back blows and chest thrusts, not abdominal
thrusts, are used to clear an obstructed airway in
a conscious infant
You need to support the infant’s head properly
throughout your efforts to clear the obstruction

Questions?
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Closing: Rescue Breathing
Child
Rescue breathing is the care you give a child
who is not breathing but has a pulse
When giving rescue breathing to a child, give 1
rescue breath about every 3 seconds. After,
about 2 minutes recheck for signs of life & a
pulse for no more than 10 seconds

Questions?
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Closing: Rescue Breathing
Infant
Rescue breathing is the care you give an infant
who is not breathing but has a pulse
When giving rescue breathing to an infant, give
1 breath every 3 seconds. After about 2 minutes
recheck for signs of life and a pulse for no more
than 10 seconds

Questions?
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