Choking and Breathing Difficulties

First Aid Training - Breathing problems

Breathing is vital to life. Every time we breathe, we not only take oxygen in but breathe carbon dioxide out. Without oxygen the cells of the body will start to die in about three minutes.

Breathing problems can be caused a number of ways; it may be through injury, such as damage to the chest wall, or disease such as cancer or emphysema. Some respiratory conditions, such as asthma or hyperventilation, can have a rapid onset and may need assistance from first aiders.

First Aid Training - Choking

A foreign object that is stuck at the back of the throat may block the throat or cause muscular spasm.

Young children especially are prone to choking. A child may choke on food, or may put small objects into their mouth and cause a blockage of the airway.

If the blockage of the area airway is mild, the casualty should be able to clear it; if it is severe they will be unable to speak, cough, or breathe, and will eventually lose consciousness.

Recognition

Mild obstruction

  • Casualty able to speak, cry, cough or breathe.

Severe obstruction

  • Casualty is unable to speak, cry, cough or breathe.
  • Casualty will eventually become unconcious without assistance.

Treatment for adult or child

Your aims are to remove the obstruction and to arrange urgent removal to hospital if necessary.

If the obstruction is mild

  • Encourage them to continue coughing.
  • Remove any obvious obstruction from the mouth.

If the obstruction is severe

  • Give up to five back blows.
  • Check the mouth and remove any obvious obstruction.

If the obstruction is still present:

  • Give up to five abdominal thrusts.
  • Check the mouth and remove any obvious obstruction.

If the obstruction does not clear after three cycles of back blows and abdominal thrusts:

  • Dial 999 (or 112) for an ambulance.
  • Continue until help arrives.

Treatment for infants

Your aims are to remove the obstruction and to arrange urgent removal to hospital if necessary.

If the infant is distressed, is unable to cry, cough, or breathe:

  • Lay them face down along your forearm, with their head low, and support the back and head.
  • Give up to five back blows, with the heel of your hand.
  • Check the infant's mouth; remove any obvious obstructions.
  • Do not do a finger sweep of the mouth.

If the obstruction is still present:

  • Turn the infant onto his back and give up to five chest thrusts.
    • Use two fingers, push inwards and upwards (towards the head) against the infants breastbone, one finger's breadth below the nipple line.
    • The aim is to relieve the obstruction with each chest thrust rather than necessarily doing all five.
  • Check the mouth.

If the obstruction does not clear after three cycles of back blows and chest thrusts:

  • Dial 999 (or 112) for an ambulance.
  • Continue until help arrives.

First Aid Training - Asthma

Introduction

In an asthma attack the muscles of the air passages in the lungs go into spasm and the linings of the airways swell. As a result, the airways become narrowed and breathing becomes difficult.

Sometimes there is a specific trigger for an asthma attack such as:

  • An allergy.
  • A cold.
  • Cigarette smoke.
  • Extremes of temperature.
  • Exercise.

People with asthma usually deal well with their own attacks by using a blue reliever inhaler, however you may be required to assist someone having an asthma attack or having an attack for the first time.

Recognition features

  • Difficulty in breathing, with a very prolonged breathing-out phase.

There may also be:

  • Wheezing as the casualty breathes out.
  • Difficulty speaking and whispering.
  • Distress and anxiety.
  • Coughing.
  • Features of hypoxia, such as a grey-blue tinge to the lips, earlobes and nailbeds (cyanosis).

Treatment

Your aims during an asthma attack are to ease the breathing and if necessary get medical help.

  • You need to keep the casualty calm and reassure them.
  • If they have a blue reliever inhaler then encourage them to use it. Children may have a spacer device and you should encourage them to use that with their inhaler also. It should relieve the attack within a few minutes.
  • Encourage the casualty to breathe slowly and deeply.
  • Encourage the casualty to sit in a position that they find most comfortable, often leaning forward with arms resting on a table or the back of a chair. Do not lie the casualty down.
  • A mild asthma attack should ease within three minutes but if it doesn’t encourage the casualty to use their inhaler again.

Caution:

If this is the first attack, or if the attack is severe and any one of the following occurs:

  • The inhaler has no effect after five minutes.
  • The casualty is becoming worse.
  • Breathlessness makes talking difficult.
  • The casualty becomes exhausted.

Dial 999 (or 112) for an ambulance.

  • Encourage the casualty to use their inhaler every five to 10 minutes.
  • Monitor and record the breathing and pulse rate every 10 minutes.

If the patient becomes unconscious open the airway and check their breathing and be prepared to give emergency aid. Please listen to the tips on recovary position and CPR.

First Aid Training - Hyperventilation

Introduction

Hyperventilation is excessive breathing, it is normally caused by acute anxiety and it may accompany a panic attack, it can also occur in individuals who have recently experienced an emotional or psychological shock.

Recognition

  • Unnaturally fast deep breathing.
  • Attention seeking behaviour.
  • Dizziness.
  • Feeling faint.
  • Trembling or marked tingling in the hands and cramps in the hands and feet.

Treatment

Your aim with somebody who is hyperventilating is to remove the casualty from the cause of distress, to reassure them and calm them down.

  • Speak to them firmly, but be kind and reassuring.
  • Remove them to a place that is quiet.
  • If this is not possible ask bystanders to leave or turn away.

Encourage the casualty to see their own doctor about preventing and controlling panic attacks in the future.

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