Dealing with Breathing Problems

This leaflet is created from first aid advice provided by St John Ambulance, the nation's leading first aid charity. This advice is no substitute for first aid training - find a training course near you.

Choking

A foreign object that is stuck at the back of the throat may block the throat or cause muscular spasm.

Young children especially are prone to choking. A child may choke on food, or may put s

Small objects into their mouth and cause a blockage of the airway.

If the blockage of the airway is mild, the person should be able to clear it; if it is severe, they will be unable to speak, cough, or breathe, and will eventually lose consciousness.

Recognition

Mild obstruction:

  • Person is able to speak, cry, cough or breathe.

Severe obstruction:

  • Person is unable to speak, cry, cough or breathe.
  • If the person doesn’t receive assistance, they will eventually become unconscious.

Treatment for an adult or a child

Your aims are to remove the obstruction and to arrange urgent removal to hospital if necessary. See below for treatment for infants.

If the obstruction is mild:

  • Encourage them to continue coughing.
  • Remove any obvious obstruction from the mouth.

If the obstruction is severe:

  • Give up to 5 back blows, with the heel of your hand, between the shoulder blades.
  • Check the mouth and remove any obvious obstruction.

If the obstruction is still present:

  • Give up to 5 abdominal thrusts, with the heel of your hand, between the shoulder blades.
  • Check the mouth and remove any obvious obstruction.

If the obstruction does not clear after 3 cycles of back blows and abdominal thrusts:

  • Dial 999/112 for an ambulance.
  • Continue until help arrives.

Treatment for infants

Your aims are to remove the obstruction and to arrange urgent removal to hospital if necessary.

If the infant is distressed, is unable to cry, cough, or breathe:

  • Lay them face down along your forearm, with their head low, and support the back and head.
  • Give up to 5 back blows, with the heel of your hand.
  • Check the infant's mouth; remove any obvious obstructions.
  • Do not do a finger sweep of the mouth.

If the obstruction is still present:

  • Turn the infant on to their back and give up to 5 chest thrusts.
    • Use two fingers, push inwards and upwards (towards the head) against the infant's breastbone, one finger's breadth below the nipple line.
    • The aim is to relieve the obstruction with each chest thrust rather than necessarily doing all 5.
  • Check the mouth.

If the obstruction does not clear after 3 cycles of back blows and chest thrusts:

  • Dial 999/112 for an ambulance.
  • Continue until help arrives.

Asthma attack

In an asthma attack, the muscles of the air passages in the lungs go into spasm and the linings of the airways swell. As a result, the airways become narrowed and breathing becomes difficult.

Sometimes there is a specific trigger for an asthma attack, such as:

  • An allergy.
  • A cold.
  • Cigarette smoke.
  • Extremes of temperature.
  • Exercise.

People with asthma usually deal well with their own attacks by using a blue reliever inhaler; however, you may be required to assist someone having an asthma attack or having an attack for the first time.

Recognition

  • Difficulty in breathing, with a very prolonged breathing-out phase.

There may also be:

  • Wheezing as the person breathes out.
  • Difficulty speaking and whispering.
  • Distress and anxiety.
  • Coughing.
  • Features of hypoxia, such as a grey-blue tinge to the lips, earlobes and nailbeds (cyanosis).

Treatment

Your aims during an asthma attack are to ease the breathing and if necessary get medical help.

  • You need to keep the person calm and reassure them.
  • If they have a blue reliever inhaler then encourage them to use it. Children may have a spacer device and you should encourage them to use that with their inhaler also. It should relieve the attack within a few minutes.
  • Encourage the person to breathe slowly and deeply.
  • Encourage the person to sit in a position that they find most comfortable, often leaning forward with arms resting on a table or the back of a chair. Do not lay the person down.
  • A mild asthma attack should ease within three minutes but if it doesn't, encourage the person to use their inhaler again.

Caution

If this is the first attack, or if the attack is severe and any one of the following occurs:

  • The inhaler has no effect after 5 minutes.
  • The person is becoming worse.
  • Breathlessness makes talking difficult.
  • The person becomes exhausted.

Dial 999/112 for an ambulance.

  • Encourage the person to use their inhaler every 5 to 10 minutes.
  • Monitor and record the breathing and pulse rate every 10 minutes.

If the patient becomes unconscious, open the airway and check their breathing; be prepared to give emergency aid.

Hyperventilation

Hyperventilation is excessive breathing, it is normally caused by acute anxiety and it may accompany a panic attack; it can also occur in individuals who have recently experienced an emotional or psychological shock.

Recognition

  • Unnaturally fast deep breathing.
  • Attention seeking behaviour.
  • Dizziness.
  • Feeling faint.
  • Trembling or marked tingling in the hands and cramps in the hands and feet.

Treatment

Your aim with somebody who is hyperventilating is to remove the person from the cause of distress, to reassure them and calm them down.

  • Speak to them firmly, but be kind and reassuring.
  • Remove them to a place that is quiet.
  • If this is not possible, ask bystanders to leave or turn away.

Encourage the person to see their own doctor about preventing and controlling panic attacks in the future.

Note: these hints are no substitute for thorough knowledge of first aid. St John Ambulance holds first aid courses throughout the country.

 

This leaflet was taken from the St John Ambulance website: choking, asthma and hyperventilation. Copyright for this leaflet is with St John Ambulance.