Breathing difficulties - first aid
DefinitionBreathing difficulties can range from being short of breath, unable to take a deep breath, gasping for air, or feeling like you are not getting enough air.This article discusses first aid for someone who is having breathing problems.See also: Choking
Alternative NamesDifficulty breathing - first aid; Dyspnea - first aid; Shortness of breath - first aid
ConsiderationsBreathing difficulty is almost always a medical emergency (other than feeling slightly winded from normal activity such as exercise).
CausesThere are many different causes for breathing problems. Common causes include:AsthmaBeing at a high altitudeBlood clot in the lungChronic obstructive pulmonary disease (COPD) Collapsed lungHeart attackHeart disease or heart failureInjury to the neck, chest wall, or lungsLife-threatening allergic reactionRespiratory infections, including pneumonia, acute bronchitis, whooping cough, croup, and others
SymptomsA person with breathing difficulty may have:Bluish lips, fingers, and fingernailsChest moving in an unusual way as the person breathesChest painConfusion, lightheadedness, weakness, or sleepinessCoughFeverGurgling, wheezing, or whistling sounds
First AidIf someone is having breathing difficulty:Immediately call 911 or your local emergency number.Check the person's airway, breathing, and pulse. If necessary, begin CPR.Loosen any tight clothing.Help the person use any prescribed medication (such as an asthma inhaler or home oxygen).Continue to monitor the person's breathing and pulse until medical help arrives. Do NOT assume that the person's condition is improving if you can no longer hear abnormal breath sounds, such as wheezing.If there are open wounds in the neck or chest, they must be closed immediately, especially if air bubbles appear in the wound. Bandage such wounds at once.A "sucking" chest wound allows air to enter the person's chest cavity with each breath. This can cause a collapsed lung. Bandage the wound with plastic wrap, a plastic bag, or gauze pads covered with petroleum jelly, sealing it except for one corner. This allows trapped air to escape from the chest, but it prevents air from entering the chest through the wound.
Do NotDo NOT give the person food or drink.Do NOT move the person if there has been a chest or airway injury, unless it is absolutely necessary.Do NOT place a pillow under the person's head. This can close the airway.Do NOT wait to see if the person's condition improves before getting medical help. Get help immediately.
Call immediately for emergency medical assistance ifCall 911 or your local emergency number if you or someone else has difficulty breathing, especially if you notice:Blue lips, fingers, or fingernailsChest painCoughing up large amounts of bloodDizziness or lightheadednessExcessive droolingFacial, tongue, or throat swellingHigh-pitched or wheezing soundsHivesInability to speakNausea or vomitingRapid or irregular heartbeatSweatingCall your doctor right away if:Shortness of breath is brought on by coughing, especially productive coughing.Your child's cough has a barking sound.You have a fever, green or yellow phlegm, night sweats, weight loss, loss of appetite, or swelling in your legs.You are coughing up small amounts of blood.
PreventionWear a medical alert tag if you have a pre-existing breathing condition, such as asthma.If you have a history of severe allergic reactions, carry an epinephrine pen and wear a medical alert tag. Your doctor will teach you how to use the epi pen.If you have asthma or allergies, eliminate household allergy triggers like dust mites and mold.Don't smoke, and keep away from secondhand smoke. Don't allow smoking in your home.If you have asthma, see the article on asthma to learn ways to manage it.Make sure your child obtains the whooping cough (pertussis) vaccine.When traveling by airplane, get up and walk around once in awhile to avoid forming blood clots in your legs. Clots can break off and lodge in your lungs. If traveling by car, stop and walk around regularly.Lose weight. You are more likely to feel winded if you are overweight. You are also at greater risk for heart disease and heart attack.
ReferencesManno M. Pediatric respiratory emergencies: upper airway obstruction and infections. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 166.Thomas SH, Brown DFM. Foreign bodies. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 57.Wippold FJ II. Diagnostic imaging of the larynx. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 106.