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Asphyxia and First Aid
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ja is tentially fatal condition, which occurs if there is not
xygen available to the tissues of the body. Such deficiency
maybe due to an insufficient amount of oxygen in the air ‘breathed in
or any interference with, or injury to the respiratory system. Without
an adequate supply of oxygen, the tissues deteriorate very rapidly.
Vital nerve cells in the brain can die after only 3 minutes without
oxygen. There are many conditions, which can result in asphyxia,
some of which are described below (Box 2.1):
1. Conditions affecting the casualty’s airway and lungs include:
a. Obstructed airway is due to the tongue falling into the back
of the throat in an unconscious casualty; food, vomit or
other foreign matter present in the airway, or swelling of the
tissues in the throat resulting from scalds, stings or infection.
Pepa pgs tue sce
z pane
While artificial respiration is being performed, instruct bystanders to ret
wet clothing as far as practicable
‘Weap the casualty in dry blanket or other dry clothing
+ Grasp the lower limbs and raise the body
7 Freed neck by loosening or cutting the rope
for a policeman,
obstruction, bend the casualty's head and shoulder forward
small child hold him/her upside down, and thump his/her 24 Section Ii First Aid in Emerg
Contd. :
+ If this is not suc
the back of,
ing has not ceased or when it has been restored give ice to suck, ¢
-cold water to sip
‘oil or medicinal paraffin may also be given
‘a towel, handkerchief or cloth, preferable wet, over your mouth ang
+ i |
in in the aise 2 i
ae ‘as quickly as possible
ventilation and deadly gas, a Gene pgeeeeworn
safety precautionisalifeline
¢ a
ii ra barrier, or pressure from a
to the spinal cord.
cygen in the blood include:
such as may be found it
and tunnels. :
at high altitudes, i"
i ea diving.
> | Chapter 2: Asphyxia and First Aid 25
4, Conditions preventing the use of oxygen in the body include:
a, Carbon monoxide poisoning.
b. Cyanide poisoning.
EXTERNAL OBSTRUCTION
External obstruction results when air is prevented from reaching
the air passages by an external obstruction such as a plastic bag, soft
pillow or a fall of sand. A baby may be suffocated through lying face
down on a pillow or cushion.
Signs and Symptoms
+ Difficulty in breathing—the rate and depth of breathing increases
+ Breathing may become noisy with snoring or gurgling.
Aims
Restore supply of air to the casualty and seek medical aid.
Treatment
1. Immediately remove any obstruction or remove the casualty to
fresh air.
2. Ifcasualty is conscious and breathing, reassure and observe.
3. If casualty is unconscious, open airway and check breathing.
Complete the airway, breathing and circulation (ABC) of
resuscitation if required and place her in the recovery position.
4, Seek medical aid, if in doubt about his/her condition, arrange
transportation to hospital:
a. Possible frothing at the mouth.
b. Blueness of face, lips and finger nails (cyanosis).
c, Confusion.
d, Lowering of level of responsiveness.
€. Possible unconsciousness.
f£, Breathing may stop.
‘i
HANGING, STRANGLING AND THROTTLING
Pressure on the outside of the neck by hanging, strangling or
throttling squeezed the airway shut and blocks off the flow of air to
the lungs; — 26 Section I: First Aidin Emergen¢ Situations
1, Hanging: It involves suspension of the body by the neck fig,
nose,
2, Strangling: It involves cutting off the air supply by a tip),
constriction around the neck. L
3. Throttling: It involves cutting off the air supply by intention,
squeezing of the person's throat, as in an assault. k
‘The first two conditions may occur accidentally, €.8. a tie may
become caught in machinery.
Signs and Symptoms
+ Body maystill be suspended
« General signs and symptoms of asphyxia
+ Congestion of the face and neck with the veins becoming
prominent
= Constriction may still be visible around neck (e.g. scarf), or it may
be hidden in the folds of the skin (e.g. wire)
« There may be marks around the casualty’s throat or neck, where a
constriction has been removed.
Aims
Restore adequate breathing and arrange transportation to hospital.
Treatment
1. Remove the constriction from around the casualty’s neck
immediately, supporting the weight of his/her body if he/she is
hanging. If there is a knot, cut below it (a knot is difficult to cut
and it may be useful evidence).
2, if the casualty is unconscious, open his/her airway and check
breathing. Complete the ABC of resuscitation, if required and
place the casualty in the recovery position.
3, Arrange the transportation to hospital,
ye Note: Seek medical aid even if recovery seems complete.
fooownne
Drowning causes asp!
the host to eeplnay ‘water entering the lungs or by causing
drowning): 80 Into spasm, so constricting the air passage ("Y
TRH
= | chapter 2: Asin ant fist nid 27
lL he not waste time trying to remove any water from the casualty’s
lungs.
2. Congestion of the lungs can occur very quickly, but it may be
several hours before it is apparent. All casualties rescued from
drowning should be sent to hospital. If a casualty has been
immersed in cold water there is also danger of hypothermia, so
itis important that the casualty is kept warm.
However, severe chilling protects the brain so that a casualty who
has suffered prolonged immersion in very cold water may make a
full recovery.
Signs and Symptoms
+ Similar to general signs and symptoms of asphyxia
+ Froth around the casualty’s lips, mouth and nostrils.
Aims
Get air into the casualty’s lungs as fast as possible by removing the
water, if necessary. Arrange transportation to hospital.
SMOKE INHALATION
A fire uses up oxygen in the atmosphere so the oxygen level in a
burning room is low and asphyxia may result. Smoke may irritate the
throat, which can go into spasm and close the airway. In addition,
the plastic coverings and foam padding of modern furnishings,
when burning, often give off highly toxic fumes, which can be fatal.
Signs and Symptoms
* General signs and symptoms of asphyxia
* Casualty may be scorched or burned (scorched hair in the nostrils
is a valuable warning sign)
) air and adequate breathing. Call the emergency
diately, Remove the casualty from the fire and smoke 28 Section II: First Aid in Emergency Situations =
Treatment
Shift the casualty to safety without endangering oneself.
FIRES
Rapid and clear thinking is vitally important when dealing with fir,
Fire spreads very quickly so warn people in the building and alert,
emergency services immediately, giving them as much information,
as possible. Try to get everyone out of the building and make si,
that all doors of room, where there is fire, are shut. Remember ¢,
not attempt to fight a fire unless you have notified the emergency
services and have made sure that you will not beinany danger ~
Modern furniture often contains synthetic materials, which
when burning, may give off toxic fumes. So you should never enter
a burning building unless equipped with and practiced in the use of
ason you do have to enter a smoke-
breathing apparatus. If for any re
{filled room, make sure you are not endangering yourself.
‘Ifyou are trapped in a burning building, the best thing to dois
jinto a room with a window and shut the door. Put a blanket or
against the bottom of the door to keep the smoke out and call
from the window.
alty is trapped in a garage with the car engine burning
rs to ensure a good supply of fresh air. Do not
until you are certain that you will not
ato
jut endangering yoursell:
or smoldering.
her holding 2 ™%
e for protection
s
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a
am
mom ne Shaper a tsp and int ad 29
b. Ifaperson’s clothing catches fire when alone, he/she should
roll on the floor, smothering the flames with the nearest
available wrap and call for assistance; on no account should
he/she rush into the open ait.
c. The use of fire guards will prevent many calamities in the
home.
3. If he/she is unconscious, open his/her airway and check
breathing, Complete the ABC of resuscitation, if required and
place his/her in the recovery position.
4, Treat any burns (refer Chapter 10 ‘Burns and Scalds’).
5. Arrange transportation to hospital.
SUFFOCATION
By Smoke
Protect yourself by tying a towel, handkerchief or cloth, preferably
wet, over your mouth and nose. Keep low and remove the casualty
as quickly as possible.
By Poisonous Gas
The gases most commonly met with may be:
1. Gases lighter than air: Carbon monoxide (found as a result of
combustion in car exhaust vapors and in household coal gas
and as a result of incomplete combustion, i.e. charcoal stoves
and as white damp in coal mines), ammonia and methane or
marsh gas (found as its name implies in marshes and as fire
damp in coal mines).
2. Gases heavier than air: Carbon dioxide (found in the black
damp of coal mines), sulfuretted hydrogen (found in sewer
gas), carbon tetrachloride (vapor from fire extinguishers),
methyl bromide (vapor from leaking refrigerators and varieties
__of compressed gas used for cooking and lighting).
entering any closed space known or suspected to contain
poisonous gas of any kind, take a deep breath and hold it. Ensure a
free circulation of air by opening or if necessary by breaking doors or
windows. If the gas is lighter than air, keep low, if heavier, remain in
the upright position. Remove the casualty as quickly as possible. In
*s where ventilation is not possible and the character of the gas is
nown to be deadly a suitable gas mask be worn. An additional safety
isalifeline. 30. Secon fist An Emergency Stations.
Carbon Monoxide Poisoning
Carbon monoxideisa colorless, odorless gas- Its fumes are dange,,,,
because carbon monoxide replaces the oxygen in the blood (), ;
more readily absorbed by the blood than is oxygen). A casualty ;,.
require prolonged artificial ventilation to clear completely. The in,,,
common sources of carbon monoxide are fumes from partially by,
fuels and motor engine exhausts. Danger arises if an exhaust syste,
is defective or if an engine is left running, in an enclosed space. fin;,,
gas-filled room to rescue a casualty only ifyou are notin any dange,
and ifyou can get out again easily. Make sure you have backup help
‘Arescue rope around the waist is a useful precaution.
Signs and Symptoms
+ Similar to general signs and symptoms of asphyxia
« Casualty may complain of a headache
olor may be normal, but will deeper to cherry pink as the level o{
bon monoxide in the blood rises
y may be confused and uncooperative
is difficult or aa stopped
en his/her airway and check
Tesuscitation if required and
rous becauls’
. The carbo? 2: Asphyxia and First Aid 31
ete COMbustion of
ide is produced by incomp! of any
Ne i dioxide may be found in mines and similar
enclosed spaces.
b. Butane and propane are used
heating, lighting or refrigerating,
connections.
at home and in industry for
and can leak from faulty
CHOKING
Choking occurs when the airway is partially or totally obstructed by
something, which in the act of swallowing, goes into windpipe rather
than down the food passage. However, choking can also be caused
by muscular spasm. Adults may choke on pieces of food, which
have been inadequately chewed and hurriedly swallowed; children
are at risk because they like putting objects inside the mouths. It is
imperative that any obstruction be removed as soon as possible.
Encourage a conscious choking casualty to cough the obstruction
out. If this does not work, attempt to dislodge it by bending the
casualty over and back slapping. Only if this fails, try to force the
remaining air out of the lungs by abdominal thrust.
Both these techniques can be used by any first aider on any
casualty (infant, child or adult) in any position (sitting, standing or
down), Administer both back slaps and abdominal thrusts up
in a sequence, but if the technique is successful the full
es not have to be completed. Always treat a casualty in the
nd (unless he/she is unconscious). If standing or sitting,
s unconscious, you have to perform artificial
to try to blow air pass the obstruction and into the
casualty the throat may relax sufficiently to
toms of asphyxia
to speak or breathe and may be gripping Situations EL
and neck with the veins becomiy,
jipsand mouth L
i
and restore normal bre:
32. Section Il: First Aid in
= Congestion of the face
prominent, blueness of th
+ Possible ‘unconsciousness.
athing. Arrange
i
bE AASPHYAIA hee 5
5 : sie
jo not} sufficient supply of fresh air vital organs
e centers in the brain, which regulate their
d of oxygen and this causes a dangerous
Inless the cause is speedily removed and
to the blood circulating through the
s ness, cessation of breathing, failure of the
yecur. ’
:
drowning.
es in the air passages, 8: coal
, after damp, smoke, sewer gas and
Aiioins el!
tthe respiratory center in addition.
passages causing choking, ¢8
vomited matter in the cas
to failure of the action of