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.

1. ASTHAMA

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 3 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 5 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 5 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 recovery position and CPR.

2. 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.
• If the casualty is unable to regain control of their breathing by doing this ask them to re-breath their own exhaled air from a paper bag.
• Ask them to hold the paper bag over their mouth and nose and breathe in and out slowly into the bag about ten times, and then breathe without the bag for fifteen seconds.
• The patient should continue to alternate this cycle of breathing with and without the bag until the need to breathe rapidly has passed.

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