Breathing Difficulties - First Aid
Breathing difficulties can be described in several different ways. You may be short of breath, unable to take a deep breath, gasping for air, or feel like you are not getting enough air.
If you are having difficulty breathing, it is almost always a medical emergency (other than feeling slightly winded from normal activity like exercise or climbing a hill).
Causes of Breathing Difficulties
Difficulty breathing has many potential causes. Some of the most common are:
- Collapsed lung, which can happen if you have emphysema or asthma, but may also happen spontaneously in young, healthy people
- Heart attack
- Heart disease, asthma, emphysema, chronic bronchitis, or heart failure
- High altitudes, which can be a problem even in young people
- Injury to the neck, chest wall, or lungs
- Life-threatening allergic reaction
- Pulmonary embolism, or a blood clot in the lung, which can cause very abrupt and severe difficulty breathing
- Sudden illness or infections like pneumonia, acute bronchitis, whooping cough, croup, or epiglottitis
Symptoms for Difficulty Breathing
The following symptoms are often associated with difficulty breathing:
- Bluish lips, fingers, and fingernails
- Chest moving in an unusual way as the person breathes (may indicate an airway or chest injury)
- Chest pain (could be a heart attack or injury; sharp chest pain could be pulmonary embolism or collapsed lung)
- Confusion, light-headedness, weakness, or sleepiness
- Cough (if the person also has phlegm/sputum, this may be pneumonia; a barking cough in a child is croup)
- Gurgling, wheezing, or whistling sounds
- Using chest and neck muscles to breathe
- Call 911 immediately.
- Check the person's airway, breathing, and circulation. If necessary, begin CPR and first aid for bleeding.
- 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 circulation until medical help arrives. DO NOT assume that the person's condition is improving if you can no longer hear 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 prevents air from entering the chest through the wound.
DO NOT do the following:
- DO NOT give the person any foods or drinks.
- 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 if he or she is lying down. This can close the airway.
- DO NOT wait to see if the person's condition improves before getting medical help. Get help immediately.
When to Contact a Medical Professional
Call 911 if you or someone else has labored breathing, especially if accompanied by:
- Blue lips, fingers, or fingernails
- Chest pain
- Coughing up large amounts of blood
- Dizziness or light-headedness
- Excessive drooling
- Facial, tongue, or throat swelling
- High-pitched or wheezing sounds
- Inability to speak
- Nausea or vomiting
- Rapid or irregular heartbeat
Call your doctor right away if:
- Your 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.
- Wear 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, 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.
Breathing - slowed or stopped
Breathing that slows down or stops from any cause is called apnea.
Apnea can come and go and be temporary. This can occur with obstructive sleep apnea, for example.
Prolonged apnea means a person has stopped breathing. If the heart is still active, the condition is known as respiratory arrest. This is a life-threatening event that requires immediate medical attention and first aid.
Prolonged apnea accompanied by lack of any heart activity in a person who is not responsive is called cardiac (or cardiopulmonary) arrest. In infants and children, the most common cause of cardiac arrest is respiratory arrest. In adults, the opposite usually occurs: Cardiac arrest leads to respiratory arrest.
Causes of Apnea
Apnea can occur for many different reasons. The most common causes of apnea in infants and small children are generally quite different from the most common causes in adults.
Common causes of apnea in infants and young children include:
- Gastroesophageal reflux (heartburn)
- Holding one's breath
- Premature birth
Common causes of apnea in adults include:
- Asthma or other lung diseases
- Cardiac arrest
- Drug overdose, especially due to alcohol, narcotic painkillers, barbiturates, anesthetics, and other depressants
- Obstructive sleep apnea
Other causes of apnea include:
- Head or brain-stem injury
- Irregular heartbeat
- Metabolic disorders
- Stroke and other neurological disorders
When to Contact a Medical Professional
See immediate medical attention or call your local emergency number (such as 911) if a person with any type of apnea:
- Becomes limp
- Has a seizure
- Is not alert (loses consciousness)
- Remains drowsy
- Turns blue
If a person has stopped breathing, call for emergency help and perform CPR (if you know how). When in a public place, look for an Automated External Defibrillator (AED) and follow the directions.
What to Expect at Your Office Visit
CPR or other emergency measures will be done in an emergency room or by an ambulance EMT (emergency medical technician).
Once the patient is stable, the health care provider will do a physical exam, which includes listening to heart sounds and breath sounds.
Questions will be asked about the person's medical history and symptoms, including:Time pattern
- Has this ever happened before?
- How long did the event last?
- Has the person had repeated, brief episodes of apnea?
- Did the episode end with a sudden deep snorting breath?
- Did the episode occur while awake or asleep?
Recent health history
- Has there been any recent history of an accident or injury?
- Has the person been ill recently?
- Had there been any breathing difficulty before the breathing stopped?
- What other symptoms have you noticed?
- What medications does the person take?
- Does the person use street or recreational drugs?
Diagnostic tests that may be done include:
- Arterial blood gas
- Chest x-ray
- Other blood tests