1. Respiration

2. Scope Respiratory system Respiratory arrest, Respiratory distress Choking –Abdominal thrust –Chest thrust Drowning and Rescue breathing Asthmatic attack Hyperventilation

3. Respiration The respiratory system Normal respiration –Effort less, steady, rhythmic, little/no noise –Rates Infant 24 – 40 cpm Child20 – 30 cpm Adult12 – 18 cpm

4. Respiration Gaseous content –Inspired air – 21% oxygen –Expired air – 16% oxygen Below 12 cpm assist ventilation Brain damage after 4 minutes without oxygen

5. Respiratory Arresst Respiratory arrest is a condition in which breathing has stopped. Cause –Result of choking, drowning, asthmatic attack etc. Sign –Casualty is unconscious –No breathing Treatment –Rescue breathing

6. Respiratory Distress Respiratory distress is difficulty in breathing. Cause –Process of Choking, drowning, asthmatic attack etc. Signs –Rapid, distress, noisy breathing and gasping –Confusion, irritability, leading to unconsciousness –Blueness of skin, cyanosis Treatment –Relate back to cause –Rescue breathing if breathing stop

7. Respiratory Distress Common cause –Foreign object obstructing airway –Crushing or penetrating chest injury –Poisonous gases –Drowning –Bronchospasm in bronchial asthma and allergic reaction

8. Choking A form of respiratory distress Airway is partially or totally obstructed –By foreign body –Tongue

9. Drowning Air cannot get into the lungs –Wet drowning –Dry drowning Do not force water out of stomach –Does not improve respiration –Drain naturally –Stomach content being aspirated Do not use abdominal or chest thrust unless –Airway obstructed or resuscitation failed

10. Drowning Treatment –Do not waste time empty water from casualty’s lung –Get help –Do rescue breathing if needed –Keep casualty warm –Arrange to medical attention even recover

11. Severe Asthmatic Attack Shortness of breath due to narrowing of air passage due to –Allergy/Influenza/Drugs/Smoke Sign –Wheezing –Distress and anxiety –Difficulty in speaking –Grey-blue skin –Dry thick cough –Severe attack –Unconscious

12. Hyperventilaton Condition of casualty breathing to fast and has his hand and feet going into spasm Cause –Excessive breathing –Anxiety –Hysteria or Panic attack

13. Hyperventilation Sign –Unnaturally, fast, deep breathing –Dizziness, faintness –Tingling or marked tingling in the hands –Cramps in hands and feet Treatment –Lead casualty to quiet space –Ask casualty to brief slowly –Let him re-breath his own expired air

14. Airway Obstruction Casualty consciousness –Conscious –Unconscious Casualty’s condition –Adults –Obese or pregnant –Infant

15. Adominal Thrust For conscious adult Face casualty and verbally confirm choking Try to ask casualty to cough Do abdominal thrust if coughing fail to clear the obstruction Also known as Heimlich maneuver

16. Heimlich maneuver Stand behind casualty Locates victim’s navel Make fist with knuckles up Grab fist with other hand Press clenched fist –Inward and upward thrust –Separate and distinct effort –Stop when object is dislodged

17. Abdominal Thrust For unconscious adult Tap shoulder and ask Call for ambulance and place casualty on his back Open airway Check breathing Perform abdominal thrust 5 times Check mouth for foreign body Try again till obstruction is clear Put casualty in recovery position.

18. Special cases Pregnant and Obese –Kneel on side of casualty –Apply thrust at middle of sternum Infants –Stroke the back holding infants leg.

19. Rescue Breathing Mouth to mouth Mouth to nose –Mouth cannot open (trismus) –Mouth is seriously injured –Casualty vomiting severely –Casualty ingested poison Special cases –Infant