Breathing difficulties - first aid

• UNDERSTANDS the signs of mild and severe choking (see here)
• UNDERSTANDS how to perform back blows & abdominal thrusts on an adult (see here)
• UNDERSTANDS the signs of other breathing difficulties i.e. hyperventilation, asthma (see below)
• UNDERSTANDS how an inhaler and spacer are used (see below)
• CAN treat and position a casualty with breathing difficulties appropriately (see below)

Examples:

• Asthma attack (see below)
• Hyperventilation (see below)
• Drowning
• Choking

Asthma: 

• Understands the signs of asthma
• Understands how an inhaler and spacer device are used
• How to position casualty appropriately = Sit up right
• When to get assistance

Hyperventilation:

• Understands the signs of Hyperventilation
• Reassurance, Encourage steady breathing (in nose, out mouth)
• How & where to position casualty
• When to get assistance

Choking: 

• Understands the signs of mild & severe choking
• Assess severity
• When & How to administer 5 back blows, 5 abdominal thrusts
• How to position casualty appropriately
• When to get assistance
• If and When to start CPR

Drowning:

• Carry out Primary Survey - (DRSABC: Danger, Response, Send for help, Airway, Breathing, Circulation)
• When to get assistance
• If and When to start CPR
• CPR for Drowning 

• difficulty breathing
• wheezing and coughing
• a tight chest, it may feel like a band is tightening around it
• distress and anxiety
• difficulty speaking, shown through short sentences and whispering
• signs of hypoxia such as a grey-blue tinge to the lips, earlobes and nailbeds
• exhaustion, in the case of a severe attack.

1. Reassure the casualty and ask them to take their usual dose of their reliever inhaler (usually blue). Ask them to breathe slowly and deeply.
2. If they have a spacer available, ask them to use it with their inhaler. The inhaler is more effective with a spacer, especially when being used for young children. ERC guidelines recognise that people with asthma may be severely incapacitated, therefore the first aider may need to help them sit upright and assist them with their medication/ inhaler.
3. If they have no inhaler, call 999 or 112 for emergency help.
4. Sit them down in a comfortable position.
5. A mild attack will normally ease after a few minutes. However, if they don’t improve within a few minutes, it may be a severe attack. Ask them to take a puff every 30 to 60 seconds, until they have had 10 puffs. Help the casualty to use their inhaler if they need assistance.
6. If the attack is severe, and they are getting worse, becoming exhausted, or if this is their first attack, call 999 or 112 for emergency help.
7. Monitor their breathing and level of response. If the ambulance hasn't arrived within 15 minutes, repeat step three.
8. If they become unresponsive at any point, prepare to give CPR.
9. If their symptoms improve and you do not need to call 999, advise the patient to get an urgent same-day appointment to see their GP or asthma nurse.

Important: This asthma attack information is not for patients on a Maintenance and Reliever Therapy (MART) plan. This may include a steroid-preventer medicine and a certain type of long-acting bronchodilator medicine which can also be used as their emergency reliever. The patient will know which they should use in an emergency and may carry a written plan. 

Drowning is when someone has difficulty breathing because their nose and mouth are submerged in a liquid.

• Do not put yourself in danger when trying to rescue a casualty.
• When the casualty is rescued from the water, you should first perform a primary survey. If this establishes that they are unresponsive and not breathing, you should ask a helper to call 999 or 112 for emergency help while you start CPR for drowning (see here).