1. First Aid for Colleges and Universities 10 Edition Chapter 17 © 2012 Pearson Education, Inc. Respiratory Emergencies Slide Presentation prepared by Randall Benner, M.Ed., NREMT-P

2. Learning Objectives Understand the disease process associated with the following conditions –Dyspnea –Emphysema –Chronic bronchitis Discuss clinical findings associated with –Dyspnea and hyperventilation –Emphysema and chronic bronchitis –Chronic obstructive pulmonary disease (COPD) –Pneumonia © 2012 Pearson Education, Inc.

3. Learning Objectives Describe the injuries and first aid care for –Dyspnea –Emphysema –Chronic bronchitis –Chronic obstructive pulmonary disease (COPD) –Asthma –Pneumonia –Hyperventilation © 2012 Pearson Education, Inc.

4. Introduction The body, mainly the lungs, must be able to provide a fresh supply of oxygen to the body at all times. A variety of medical conditions can interfere with this process. If the pulmonary mechanism fails, cells will start to die rapidly from oxygen starvation, sometimes within minutes. © 2012 Pearson Education, Inc.

5. Dyspnea What is dyspnea? –One of the most common medical complaints –Sensation that the victim cannot breathe –Body perceives the need for more oxygen –Many symptoms of dyspnea are actually the body working harder to breathe. Not a disease itself, rather a symptom of several diseases Basic symptoms include rapid, shallow breathing, and “shortness” of breath (labored breathing) Is not associated with normal “shortness” that can occur after exercise or exertion © 2012 Pearson Education, Inc.

6. Management of Dyspnea Take standard precautions, activate EMS. Clear the airway, assess ABC functions. Ventilate or provide assisted ventilations if breathing is inadequate. If breathing adequately, place patient in position of comfort. Monitor and reassure the patient until EMS arrives. © 2012 Pearson Education, Inc.

7. Chronic Obstructive Pulmonary Disease Emphysema –Damage to air sacs results in diminished ability to oxygenate the blood Chronic bronchitis –Condition occurs when the bronchioles are chronically inflamed –Results in mucous production, bronchiole obstruction, and coughing up sputum COPD victims usually have both emphysema and chronic bronchitis. –Most important risk factor is smoking. © 2012 Pearson Education, Inc.

8. Chronic Obstructive Pulmonary Disease © 2012 Pearson Education, Inc.

9. Chronic Obstructive Pulmonary Disease Emphysema symptoms –“Pink puffers,” evidence of weight loss –Progressive dyspnea, limitation of activity –Coughing with minimal mucous production Chronic bronchitis symptoms –“Blue bloaters,” weight gain, extremity swelling –Coughing with mucous production –Wheezing and low pitched snoring with breathing © 2012 Pearson Education, Inc.

10. First Aid for COPD Take standard precautions, activate EMS. Establish an airway and ventilate; monitor and assist ABCs as needed. If unconscious, place the victim in lateral recumbent or modified HAINES position. Maintain the victim’s body temperature. Loosen restrictive clothing. Monitor and reassure the patient until EMS arrives. © 2012 Pearson Education, Inc.

11. Asthma What is asthma? –Increased sensitivity of the airways –Types include acute asthma and status asthmaticus What are asthma symptoms? –Bronchospasm –Swelling of bronchiole mucous membranes –Mucous production with bronchiole plugging –Episodic dyspnea, sometimes severe and potentially fatal © 2012 Pearson Education, Inc.

12. Symptoms of Asthma Patient often sits upright (tripod positioning) Spasmodic, unproductive cough Wheezing upon expiration Hyperinflated chest with air trapping Shallow, rapid respirations Rapid pulse Use of accessory muscles to breathe Fatigue as the patient starts to deteriorate © 2012 Pearson Education, Inc.

13. First Aid Care for Asthma Take standard precautions, activate EMS. Establish an airway and ventilate; monitor and assist ABCs as needed. Position a conscious victim comfortably. Assist the victim with a prescribed asthma inhaler, if needed. Monitor and reassure the patient until EMS arrives. © 2012 Pearson Education, Inc.

14. Status Asthmaticus Severe or prolonged asthma attack Symptoms include –Severe hyperinflation of lungs, minimal breath sounds upon auscultation –Cyanosis, extreme dyspnea, exhaustion Treat the same as traditional asthma, but increase the urgency of interventions. © 2012 Pearson Education, Inc.

15. Status Asthmaticus © 2012 Pearson Education, Inc.

16. Pneumonia What is pneumonia? –A group of illnesses comprising a serious lung infection that fills the alveoli with fluid or pus, limiting gas exchange Symptoms of pneumonia –Appears ill, often has dyspnea and tachypnea –Possible fever (often over 101 degrees F) –Chest pain with breathing –Productive cough, often with sputum or mucous mixed with blood –Hot, dry skin –Labored, distressed, rapid respiration © 2012 Pearson Education, Inc.

17. First Aid Care for Pneumonia Take standard precautions, activate EMS. Position a conscious victim comfortably. Establish or maintain an airway. Provide artificial ventilations if needed. Loosen tight or restrictive clothing. Monitor and reassure the victim until EMS arrives or the patient is transported to a physician. © 2012 Pearson Education, Inc.

18. Hyperventilation What is hyperventilation? –Condition of “over breathing” –Hyperventilation syndrome is an abnormal state where patient hyperventilates for too long. –Often follows anxiety or emotional stress –Is benign unless it indicates a more serious underlying medical condition. –Patient’s history should clarify if condition is benign or may have complications © 2012 Pearson Education, Inc.

19. Signs and Symptoms of Hyperventilation Marked anxiety, leading to panic Air hunger (patient complains of dyspnea) Abdominal discomfort or bloating Carpopedal spasms (in hands and fingers) Light-headedness or fainting Tightness or lump in throat, dryness in mouth Feeling of impending doom Weakness Blurred vision © 2012 Pearson Education, Inc.

20. First Aid Care for Hyperventilation Remain calm and reassuring. Have the patient mimic your own (slow) breathing. Instruct the patient to breathe through nose, hold their breath, and then exhale. Explain what is happening at all times. Never treat by having victim breathe into a paper bag. Transport the victim to the hospital or activate EMS. © 2012 Pearson Education, Inc.

21. Summary Dyspnea is one of the most common emergency complaints. In treating dyspneic victims, you should always rule out airway obstruction. The most important risk factor in COPD is smoking. © 2012 Pearson Education, Inc.

22. Summary COPD encompasses both emphysema and chronic bronchitis. The main goals of asthma first aid care are to improve oxygen uptake, relieve bronchospams, and improve ventilation. Pneumonia is a group of illnesses causing serious lung inflammation, and requires immediate attention. Hyperventilation is usually benign unless it's caused by an underlying medical condition. © 2012 Pearson Education, Inc.