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Respiratory Emergencies

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Respiratory Emergencies Chapter 6 Respiratory Emergencies ♦ KNOWLEDGE OBJECTIVES 1. List at least four signs and symptoms 5. List five causes of choking. of respiratory distress. 6. Describe how to care for a conscious 2. Describe how to care for a casualty casualty with an obstructed airway. of respiratory distress. 7. Describe how to care for an 3. Explain when to provide rescue unconscious casualty with an breathing. obstructed airway. 4. Describe how to provide rescue 8. Define the key terms for this chapter. breathing for an adult, child, and infant. ♦ SKILL OBJECTIVES After reading this chapter and completing the class activities, you should be able to: 1. Demonstrate rescue breathing for an 3. Demonstrate emergency care for an adult, a child, and an infant. unconscious adult, child, and infant with an obstructed airway. 2. Demonstrate how to care for a conscious adult, child, and infant 4. Make appropriate decisions about with an obstructed airway. care when given an example of an emergency in which a person is having difficulty breathing. 67 ♦ OUTLINE ♦ KEY POINTS Introduction 97 Asthma The Breathing Process 97 Facts Prevention of Choking 98 ♦ Narrowing of air passages. Respiratory Distress 99 ♦ Common in children. Signs and Symptoms of Respiratory ♦ Controlled by medication. Distress 99 Triggered by Specific Types of Respiratory Distress 99 ♦ Allergic reaction to pollen/food/a drug/ insect stings. Care for Respiratory Distress 100 ♦ Emotional stress/physical activity. Respiratory Arrest 101 Signs and symptoms Rescue Breathing 102 ♦ Wheezing when exhaling. Special Considerations for Rescue Breathing 102 Emphysema Infants and Children 106 Facts Airway Obstruction 106 ♦ Lungs lose ability to exchange carbon dioxide and oxygen Partial Airway Obstruction 107 effectively. Complete Airway Obstruction 107 Triggered by: Care for Choking Casualties 108 ♦ Smoking; usually develops over Special Considerations for Choking many years. Casualties 111 Signs and symptoms Children and Infants 112 ♦ Shortness of breath. ♦ Possible coughing, cyanosis, or high fever. ♦ Advanced cases: Restlessness, confusion, weakness. 68 Bronchitis Anaphylactic Shock Facts Facts ♦ Excessive mucous secretions and ♦ Swelling of air passages restricts inflammatory changes to the breathing. bronchi. ♦ Also known as anaphylaxis. Triggered by Triggered by ♦ Exposure to irritants like cigarette smoke. ♦ Severe allergic reaction to food/insect stings/a drug. Signs and symptoms Signs and symptoms ♦ Shortness of breath. ♦ Skin rash. ♦ Coughing with sputum. ♦ Tightness in the chest/throat. ♦ Cyanosis. ♦ Swelling of the face/neck/tongue. Hyperventilation Facts ♦ Rapid breathing causes upset in body's balance of oxygen and carbon dioxide. Triggered by ♦ Fear/anxiety. ♦ Injury to head/severe bleeding/illness. ♦ Asthma. ♦ Exercise. Signs and symptoms ♦ Shallow, rapid breathing. ♦ Dizziness. ♦ Numbness in fingers/toes. 69 Care for Respiratory Distress Give Breaths General care ♦ Adults: 1 every 5 seconds. ♦ Emergency Action Principles. ♦ Children: 1 every 3 seconds. Specific care ♦ Infants: 1 every 3 seconds. ♦ Maintain normal body temperature. Airway Obstruction ♦ Have casualty rest in a comfortable Anatomical - Throat blocked by position. anatomic structure. ♦ Reduce heat and humidity. ♦ Tongue. ♦ Administer supplemental oxygen. ♦ Swelling of mouth and throat. ♦ Summon more advanced medical Mechanical - Throat blocked by foreign care. object. ♦ Monitor vital signs. ♦ Food. Key Points of Respiratory Arrest ♦ Toy. ♦ Life threatening. ♦ Fluid. ♦ Caused by illness, injury, or choking. Airway Obstruction ♦ Often preceded by respiratory Partial - Casualty can still move air to distress. and from the lungs; can cough, speak. ♦ Body systems will progressively fail. Complete - Casualty is unable to speak, breathe, or cough; no air movement. 70 ♦ LEARNING ACTIVITIES Matching Short Answer Match each term with its definition. Write its Read each statement or question and write letter on the line in front of the definition. the correct answer or answers in the space provided. Terms 1. List the four situations in which it is a. Respiratory distress appropriate for you to stop rescue breathing. b. Airway obstruction 1. c. Respiratory arrest 2. d. Aspiration 3. e. Head-tilt/chin-lift 4. Definitions 2. List four common causes of choking. 1. A technique for opening the airway 1. 2. The condition in which breathing has stopped 2. 3. A blockage that prevents air from 3. reaching the lungs, causing respiratory arrest or distress 4. 4. The condition in which breathing is 3. List at least six signs and symptoms of difficult respiratory distress. 5. Taking blood, saliva, vomit, or other 1. foreign matter into the lungs 2. 3. 4. 5. 6. 71 ♦ CASE STUDIES 4. How would you find the correct hand position for delivering chest thrusts to Read the case studies and answer the this infant? questions that follow. Case 6.1 You are summoned to a home where you find a 3-month-old baby girl in her crib, 5. T F When you deliver rescue struggling and cyanotic. You hear very high- breathing to this infant, you pitched wheezes but do not see any rise and should cover her nose and mouth fall of the chest, or hear or feel any air going with your mouth to give the in and out at the mouth and nose. She is not puffs. crying. Case 6.2 1. If you suspect an obstructed airway, At a scene where a car crashed into a utility what will you do first to try to clear the pole, you find the driver unconscious on the obstruction from the airway? ground. He is bleeding slightly, but not a. Give two slow puffs. severely, from wounds on his forehead and left cheek, and does not appear to be b. Tilt her head back, and pull up on the breathing. jaw. 1. How should you first attempt to open his c. Administer 5 chest thrusts using two airway? fingers. a. Use the head-tilt/chin-lift to move his d. Give 5 back blows. tongue away from the back of the throat. 2. Describe how you will position the infant initially to begin your emergency b. Pull his lower jaw forward by putting care? your thumb in his mouth and your fingers on the jaw. c. Lift his chin using a two-handed jaw thrust technique without tilting the 3. T F When you deliver back blows or head back. chest thrusts to this infant, her d. Turn his head to the side, and clear head should be kept higher than any blood and foreign matter from the rest of her body. his mouth. 72 2. The preferred method of rescue breathing to use with this casualty is: a. Mouth-to-mouth b. Mouth-to-mouth and nose. c. Mouth-to-nose. d. Mouth-to-mask. 3. Describe what you would do if the casualty vomited during your attempts at rescue breathing. 4. T F You should check this casualty for a pulse as soon as you have brought the chin forward to clear the airway. 5. As you continue rescue breathing, how often would you recheck the pulse? 6. At which point would you care for the bleeding injuries? a. Before calling for advanced medical help b. After you interview the casualty c. During the secondary survey d. As soon as you have begun rescue breathing 73 ♦ SELF-ASSESSMENT Circle the letter of the best answer. 1. When giving back blows to a choking 4. What should you do when a casualty is infant, the head should be breathing rapidly and you are certain it is caused by emotion? a. Higher than the chest. a. Place the casualty on one side to ease b. Turned to the side. breathing. c. Lower than the chest. b. Administer oxygen, if it is available. d. Resting on your thigh. c. Ask the casualty to try to breathe slower as you are breathing. d. Assist the casualty in taking his or 2. When performing rescue breathing, what her prescribed medication. should you do after giving the first 2 slow breaths? a. Reposition the head. 5. When you provide rescue breathing to a casualty, you are b. Check for a pulse. a. Artificially circulating oxygenated c. Check for consciousness. blood to the body cells. d. Repeat the two breaths. b. Supplementing the air the casualty is already breathing. 3. If the casualty's head is not tilted back c. Supplying the casualty with oxygen far enough when you deliver breaths necessary for survival. during rescue breathing, what will d. All of the above. happen? a. Air will go into the casualty's stomach. 6. One sign of respiratory distress is b. Oxygen will not get to the casualty's a. Pain in the abdomen. tissues. b. Rapid or slow breathing. c. Air will not reach into the casualty's lungs. c. Constricted pupils. d. The casualty's pharynx will rupture. d. Ringing in the ears. 74 7. Which is a common cause of choking? 10. Which first aid technique is used to provide oxygen to a casualty of a. Drinking alcohol before or during respiratory arrest? meals a. Mechanical breathing b. Wearing dentures b. Oxygen supplementation by mask c. Eating small pieces of well-chewed food c. Rescue breathing d. a and b d. Abdominal thrusts 8. After discovering that your first 2 11. A blue skin colour that results from too breaths are not causing the casualty's little oxygen in the blood is: chest to rise, what should you do? a. Hypoxia. a. Retilt the head and give breaths again. b. Cyanosis. b. Begin rescue breathing. c. Anaphylaxis. c. Give 2 more breaths with force. d. Edema. d. Do a finger sweep. 12. Where should you position your hands when giving abdominal thrusts to a 9. Which would be included in your care conscious choking adult or child? for an unconscious choking child? a. In the middle of the abdomen well a. Positioning on back below the navel. b. Repeated abdominal thrusts until b.
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