Chapter Four

When Seconds Count

Objectives1. Identify five signs and symptoms of respiratory

distress.2. Describe the care for a person experiencing

respiratory distress.3. Describe the purpose of rescue breathing.4. Describe when and how to provide rescue breathing

for a child and infant.5. Describe special considerations for rescue breathing.6. Describe the care for conscious and unconscious

choking for adult, child, and infant victims.7. Describe what the recovery position and H.A.IN.E.S.

position is and why it is used.

The Breathing Process

Normal breathing requires the respiratory, circulatory, nervous, and musculoskeletal systems to work together.

When you breathe air into your lungs, the oxygen in the air is transferred to the blood.

The blood transports the oxygen to the brain, other organs, muscles, and other parts of the body where it is used to provide energy.

The Breathing Process

Why time is critical…

0 minutes Breathing stops. Heart will

soon stop beating. 4 – 6 minutes

Brain damage possible. 6 – 10 minutes

Brain damage likely. Over 10 minutes

Irreversible brain damage certain.

Breathing emergencies can be caused by - An obstructed airway Illness Certain respiratory conditions that can inhibit

breathing Electrocution Drowning Heart attack Injury to the head, chest, or lungs Allergic reactions

Respiratory Distress

Most common type of breathing emergency. It is a condition in which breathing becomes

difficult. Signs & Symptoms

Slow or rapid breathing, gasping Wheezing, gurgling, high pitched noises Skin is moist or cool, flushed, pale, ashen, or

bluish Victim feels dizzy or lightheaded Victim feels apprehensive or fearful

Care for Respiratory Distress

Call 9-1-1. Help the person rest in a comfortable

position. Provide fresh air. Help maintain normal body temperature. Calm and reassure the victim.

Choking

Choking occurs when a person’s airway has been blocked by a foreign object, swelling in the mouth or throat, or by fluids such as vomit or water.

Universal Sign for Choking

Care for a Conscious Choking Adult or Child Give five back blows and five abdominal

thrusts until the object is dislodged and the person can breathe or becomes unconscious.

Hand Position for Abdominal Thrusts

Care for a Conscious Choking Infant Give five back blows and five chest thrusts

until the object is forced out, the infant begins to breathe on his or her own or the infant becomes unconscious.

Care for an Unconscious Choking

Adult or Child This care would be given –

During your check for life threatening conditions, when an unconscious person is not breathing and the 2 rescue breaths do not go in.

When a conscious choking person becomes unconscious.

Care for an Unconscious Choking

Adult or Child After your initial check, when your first two rescue breaths do not go in, retilt the head and try your breaths again.

If your breaths still do not go in, you are going to perform a modified CPR technique.

Care for an Unconscious Choking

Adult or Child Locate the correct hand position. Compress the victim’s chest 30 times in about 18 seconds.

Chest compression depth Adult – 1 ½ - 2 inches Child – 1 - 1 ½ inches

Look for a foreign object, if you see an object, sweep it out. Give 2 rescue breaths. If your breaths do not go in, repeat chest compressions until –

The object is removed and the chest rises with rescue breaths. The person starts to breath on their own. Another trained responder arrives. You are too exhausted to continue. The scene becomes unsafe.

Care for an Unconscious Choking Infant There are some minor changes when

providing care for an infant – Hand position – two fingers in the middle of the

chest Compression depth – ½ inch to 1 inch deep Sweep the mouth with your little finger

Rescue Breathing

When a child or infant stops breathing, you will have to breath for them.

You do not give rescue breathes for an adult. If an adult is unconscious and not breathing

one should assume that they are have a cardiac emergency and provide proper care.

Rescue Breathing - Children & Infants After you have given two rescue breathes

and determined that the victim has a pulse you begin rescue breathing.

You should give 1 rescue breath every 3 seconds.

After 2 minutes, recheck for signs of life and pulse for no more than 10 seconds to make sure the heart is still beating.

Rescue Breathing – Breathing Barriers Helps protect you from contact with blood

and other body fluids, as well as from breathing in the air that the person exhales.

Examples include face shields and resuscitation masks.

Special Situations – Rescue Breathing Air in the stomach

This occurs when you breath too long or too hard. Air in the lungs can cause a person to vomit, and that vomit

can enter the persons lungs. This is called aspiration. Vomiting

If the person vomits, roll them on to one side and wipe the mouth clean.

Once you have cleared away the vomit, roll the person back on to his or her back and continue rescue breathing if necessary.

Recovery Positions

Recovery Position

Used for a victim that is not suspected to have a spinal injury.

H.A.IN.E.S. Recovery Position

Used for a victim with a suspected spinal injury.