HORN INTERNIONAL

UNIVERSITY

Chapter two
Respiratory emergencies
Chapter outline

• Overview of respiratory anatomy

• Definition of respiratory emergency and artificial
respiration
• Common causes of respiratory emergencies
• Signs and symptoms of respiratory emergency
• First aid management of respiratory emergencies
Mouth to mouth respiration
Cardiopulmonary resuscitation (CPR)
• Indications of CPR
• Choking
breathing emergencies
Introduction to respiratory emergency

• The human body needs a constant supply of oxygen to

survive.
• When you breathe through your mouth and nose, air travels
down your throat, through your windpipe and into your
lungs.
• This pathway from the mouth and nose to the lungs is called
the airway.
• Normal breathing is regular, quiet and effortless. A person
does not appear to be working hard or struggling when
breathing normally.
Definition of respiratory emergency

• A respiratory emergency is one in which normal

breathing stops or in which breathing is so reduced
that oxygen in take is insufficient to support life.
• N.B. Artificial respiration: is a procedure for using
air to flow in to and out of persons. Lungs when
natural breathing is inadequate or stops.
• Common causes of respiratory
failure (problems)
• Obstruction of the air way by tongue is
dropping back.
• Inhalation of a small amount of food,
smoke, irritation, foreign objects, carbon
monoxide, etc.
• Compression of the neck
• Respiratory disease and Drowning
Organs of the
Respiratory System

7
signs and symptoms of respiratory
emergency
• Un able to breath
• breathing is very rapid or very low
• Loss of consciousness
• chest pain
• General pallor (paleness)
• Difficult in breathing or shortness of breath
• May be no visible breathing
First Aid management of Respiratory
problem

• Shout for help (depend on the condition)

• Determine the consciousness of the causality by
taping the victim on the shoulder and asking
loudly “Are you oky!”
• Assess and ensure that patient air way is clear
• Place the patient flat on his back with the head
turned to one side
• Remove any thing which is preventing the taking
in of air (Remove constraints from the neck)
• Kneel beside the patient’s head place one hand under
his neck and the other hand under his lower Jaw
extend his head and neck gently back ward.
• This prevents the tongue from falling back in to the
throat.
• Place your cheek and ear close to the victim’s mouth
and Nose. Look at the victim’s chest to see if it rises,
falls, and listen and fell for air to be exhaled for about
5 seconds.
• If there is no breathing pinch the victim’s nostrils
shut with thumb and index finger of your hand that
is pressing on the victim’s forehead.
• This action prevents leakage of air when the lungs
are inflated through the mouth.
• Take very deep breath and hold it.
• Fit your mouth tightly over the patients open
mouth and forcibly in to the lungs
• While carrying out respiration, check the
patient’s pulse every 2 or 3 minutes to ensure
the heart has not stopped.
• Continue the breathing procedure at the rate 12
to 18 breaths per minute until the chest is seen
to rise and the patient is breathing for him self
or until is certain his is dead.
 If a patient is child, our mouth should cover both
his nose and mouth.
 Very gentle breathing should be used and the
younger the child, the gentler this should continues
at a rate of 25 breaths per minute.
 Once the patient can breathe by him self/her self
place him/her in what is called the recovery
position
If mouth to mouth is failed and no pulse
cardiopulmonary resuscitation is
followed.
Cardiopulmonary resuscitation (CPR) or
heart lung resuscitation is a combined effort
to maintain circulation and breathing.
 Is an emergency procedure applied when
heart and lung actions have stopped.
Cardiopulmonary resuscitation(CPR)

• is an emergency life saving procedure done when

person’s breathing and heart stops.
During CPR you will have to perform procedures
to:
 Maintain an open airway to maintain circulation
 Breathe for the patient and force the patients
blood to circulate
Indications of CPR

• cardiac arrest
• respiratory arrest
• CO2/CO poison
• Electric shock
• Airway obstruction
• Drug reactions
Assessment for CPR

• Apnea
• Absence of pulse
• Dilated pupil
• Unconsciousness
• Cyanosis
Procedure of CPR
• If one First Aider
• first check around &make sure safety
1. check unresponsiveness
2. Assess pulse not more than 10 seconds.
3. if no pulse call EMS or ambulance
4. perform chest compressions
5. Open airway by:
-head tilt-chin lift method
-Jaw thrust maneuver
6. Locate Compression site
7. Position your hands below the breast bone
8. Began compressions (30:2)
9. Ventilate twice
10. Recheck pulse after 4cycls of ventilation, then
every few minutes
If two first aider rescuer CPR

1. Determine unresponsiveness
2. Open the air way, look, listen, (feel 3-5 seconds)
3. Ventilate twice ( 1 -2 seconds per breath ).
4. Determine no pulse and locate CPR compression
site
5. Say “No pulse.” Begin compressions
6. Ventilate once (1-2 seconds) Stop mouth-to-mouth
ventilation.
7. Continue with one ventilation every five
compressions.
8. After 10 cycles, reassess breathing and pulse.
No pulse says, “Continue CPR.” Pulse- says,
“Stop CPR.”
NOTE: Assess for spontaneous breathing and
pulse for 5 seconds at the end of the first minute,
then every few minutes there after.
Compressions
Adult Child <8yrs Infants
Pulse asses.t carotid femoral Brachial/fem
oral
Compressions Two hands Two/1hand Two fingers
method
Compressions Lower ½ Same as adult Just below
sternum b/w nipples
nipples
Compression 2inch at least Max, 2inch or 1 ½ inch
depth or 5cm 5cm
Compression 100/min 100/min 100/min
rate
compressions vs ventilation(according to
rescuer)

Adult Child <8yrs infants

1 rescuer 30:2 30:2 30:2

2 rescuers 30:2 15:2 15:2
Choking

• Choking is a common breathing emergency.

• occurs when airway is partially or completely
blocked.
• If a conscious person is choking, his or her airway
blocked by:
- foreign object-food
-fluids-vomit, blood
• partially blocked airway-able to breath and cough.
• completely blocked-cannot cough, speak, cry or
breathe at all.
Causes of choking in adults

• Trying to swallow large pieces of poorly chewed

food.
• Drinking alcohol before or during meals.
• Wearing dentures.
• Eating while talking excitedly or laughing, or eating
too fast.
• Walking, playing or running with food or objects in
the mouth
Causes of choking in infants and children

• Choking is a common cause of injury and death in

children younger than 5 years.
• Because young children put nearly everything in
their mouths.
• (AAP) recommends that young children not be
given hard, smooth foods such as raw vegetables.
• AAP recommends not giving children peanuts until
they are 7 years of age.
Signs and symptoms of choking

• Signals of choking include:

• Coughing, either forcefully or weakly.
• Clutching the throat with one or both hands.
• Inability to cough, speak, cry or breathe.
• Making noises while inhaling or noisy breathing.
Bluish skin color.
Losing consciousness if blockage is not removed
First aid management for choking adult or
child
• If the choking person is coughing forcefully, let him
or her try to cough up the object.
• encourage him or her to continue coughing
• those completely blocked airway needs immediate
care
• To dislodge an object use this technique.
• A combination of 5 back blows
• and 5 abdominal thrusts
• to clear the airway obstruction
• To give back blows,
• stand behind the person.
• Provide support
• bend the person forward at the waist
• Firmly strike the person between the shoulder blades
• To give abdominal thrusts
• Stand behind and wrap your arms around his or her
waist.
• Grasp your fist with your other hand and
• give quick, upward thrusts into the abdomen.
Caring for a Conscious Choking Infant

• for conscious infant not cough, cry or breathe.

• Give a combination of:
• 5 back blows followed by 5 chest thrusts

fig:2.1 Giving back blows chest thrust of an infant

• To give chest thrusts:
• Place the infant in a face-up position.
• Place one hand and forearm on the child’s back
• Lower your arm
• Place pads of your finger on the center of chest
and compress the breastbone

fig:2.2 chest thrust

CONSCIOUS CHOKING—ADULT
CANNOT COUGH, SPEAK OR BREATHE

• give 5 back blows

• give 5 abdominal thrusts
• Cover your fist with your other hand.
• Give 5 quick, upward abdominal thrusts.

• continue care-until the:

• Object is forced out.
• Person can cough forcefully or breathe.
• Person becomes unconscious.

fig:2.3 adult back blow

thanks you for your
attention