Breathing difficulty or shortness of breath is a medical emergency. It is generally caused by an underlying medical illness such as asthma, allergic reaction, heart failure, or lung disease.
At rest, normal breathing is regular and effortless. You may first suspect difficulty when there is a noticeable increase in the effort to breathe and the rate at which breaths are occurring.
Unusual breathing sounds may occur. A bluish-purple tissue color, especially in the lips or fingers, indicates a developing lack of oxygen and is a serious sign. Do not wait to see if a person's condition will improve.
Activate EMS without delay. If an AED is available, have someone get it. Allow the person to find the most comfortable position in which to breathe. Loosen any tight clothing. Calm, comfort, and reassure the person until another provider or EMS personnel take over.
Breathing difficulty can quickly become life threatening as a person becomes exhausted from the breathing effort. Keep the person as comfortable and calm as possible. Reassess regularly until another provider or EMS take over.
Be prepared to provide CPR and attach an AED if the person’s condition worsens. Asthma, or reactive airway disease, affects the small air passages in the lungs. Irritants can trigger a reaction that results in narrowed passages due to swelling and the production of mucus.
Airflow into and out of the lungs is restricted. Asthma symptoms can vary from mild to life threatening. Quick-relief medications that work fast to control asthma symptoms are available. If the person has a prescribed inhaler for asthma, assist him or her in using it. If the person does not improve within fifteen to twenty minutes, activate EMS.
Assisting with Medication State laws and regulations may prescribe specific practices, rules, and standards for assisting another person with prescribed medication. Be aware of the regulations in your local area.
Respiratory Emergencies - Acute (sudden) shortness of breath (SOB), a symptom of respiratory distress, is a medical emergency. There can be many causes, including heart attack, asthma, collapsed lung, pulmonary embolism, congestive heart failure, allergic reaction, choking, emphysema, bronchitis, and respiratory illness. Electrocution, poisoning, or an injury to the head or trunk can also cause respiratory distress.
Generally, the treatment for respiratory emergencies is the same. Fast recognition of the emergency together with prompt activation of EMS (9-1-1) is critical. Delay can be fatal.
Signs and Symptoms: Breathing rate: Too fast or too slow; agonal breathing (gasping, irregular, or only a few breaths per minute)
Labored breathing: Using shoulder and back muscles to assist breathing
Broken dialogue: Speaking in short sentences or one word answers, pausing for breath.
Color: Ashen, pale, cyanotic (blue skin, especially around the lips and fingernail beds) Cough, fever Dizziness, confusion
Chest pain: Caused by injury, heart attack, collapsed lung or pulmonary embolism.
Children: Nasal flaring, rib retraction (pulling inward of the ribs with breathing)
Treatment: 1. Assess response, breathing, circulation and appearance. 2. Activate EMS (call 9-1-1). 3. Position of comfort, usually sitting up. 4. Loosen tight clothing. 5. Monitor status closely until EMS responders arrive.
Congestive heart failure (CHF): A condition in which the heart gradually fails in its ability to deliver blood to the tissues of the body. The result is a buildup of fluid in the legs, ankles and feet, and a backup of fluid into the lungs, leading to SOB. CHF can be caused by heart attack or heart disease.
Chronic obstructive pulmonary disease (COPD): A group of lung diseases, including chronic bronchitis and emphysema, which limit the flow of air into and out of the lungs. Approximately 80% of all cases are caused by heavy, long-term cigarette smoking. Other causes include repeated infections, such as pneumonia, and inhalation of toxic agents, such as industrial gases.
The main signs and symptoms are SOB, chronic cough, fatigue, weight loss, and excess mucus production (bronchitis). Although COPD cannot be cured, it can be treated. A patient may use an inhaler or supplemental oxygen to help breathe better. People who quit smoking will also stop, or at least slow, the progression of emphysema. Exercise (with medical clearance), proper diet, adequate rest, and stress management will also help prevent exacerbation of COPD.
Respiratory Illnesses Croup is usually seen in children ages 3 months to 3 years, with age 21 months being the most common. Croup is caused by viral agents and is characterized by a barking cough, stridor (a high-pitched sound during obstructed breathing), wheezing, mild retractions and fever.
Signs and Symptoms: Difficulty breathing Inability to swallow Tripod position Hoarseness Retractions (pulling inward of the ribcage)
Barking cough Fever Treatment: 1. Assess response, breathing, circulation and appearance. 2. High humidity therapy (Fill bathtub or sink with hot, steamy, water.) 3. Use humidifier if available. 4. Give ibuprofen and use cooling measures for fever. If fever should spike greater than 102° F, notify a physician.
Respiratory Syncytial Virus (RSV) is a common virus that causes cold-like symptoms in adults and older children, but can be more serious in babies. It is more prevalent in the infant/toddler age group. It commonly occurs in the fall/winter months.
Signs and Symptoms: Low-grade fever Slight cough Profuse, thick, clear nasal secretions Watery eyes Labored, rapid breathing; shortness of breath.
Treatment: 1. Bed rest 2. Encourage fluids (to thin the secretions and prevent dehydration). 3. Suction nose with bulb syringe to clear nasal passageway.
Pneumonia is a respiratory condition that affects millions of people of all ages in the U.S. each year. It can be especially serious for older adults or those with chronic illnesses. Pneumonia can be caused by various agents (e.g. bacterial infections, viral infections, aspiration). The infection can destroy lung tissue and cause fluid build-up in the surrounding normal lung tissue.
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