Asphyxia

WHAT YOU SHOULD KNOW

Asphyxia is the lack of oxygen that results when breathing is stopped or seriously disrupted. Without a steady supply of oxygen, the body's vital functions shut down within four to six minutes.

Causes

Asphyxia typically results from near drowning, electric shock, inhaling poisonous gas or toxic smoke, or choking.

Signs/Symptoms

Look for chest movement. If none can be seen, breathing has stopped. The victim's skin will be pale or slightly bluish in color.

Care

Immediate mouth-to-mouth resuscitation is needed to restore breathing. Cardiopulmonary resuscitation (CPR) will restore blood circulation, but is best done by someone trained in the technique. Follow-up treatment depends upon the cause of the asphyxia. In all cases, hospitalization is required to provide intensive lung therapy and ensure that enough oxygen gets back into the bloodstream.

Risks

Permanent brain damage or death can result if breathing is not restored within four to six minutes. THIS IS AN EMERGENCY. Call 911 or 0 (operator) for paramedic assistance. Provide mouth-to-mouth resuscitation (and CPR if you've received training) while waiting for help.

WHAT YOU SHOULD KNOW

While waiting for help to arrive:

• Remove the victim from further danger.
• If the victim has suffered an electrical injury, be sure to shut off the source of the current before touching him.
• Lay the victim on a firm, flat surface, face up.
• Loosen all clothing around his neck, chest, and waist.
• If you suspect a head or neck injury, move the person as little as possible to reduce the risk of paralysis.
• Open the airway by gently tilting the head back and pulling the chin down to open the mouth. Remove any foreign material present.
• If you suspect a neck injury, open the airway by placing your index fingers under the jaw and lifting upward and outward. This opens the airway passage without moving the neck.
• Determine whether the victim is breathing. Look at the chest for signs of movement, put your ear to the victim's nose and mouth and listen for breathing, or feel for the flow of air.
• Provide artificial respiration if the victim is not breathing. Pinch the victim's nose closed. Take a deep breath and place your mouth tightly over the victim's mouth. Blow until the victim's chest rises. Listen for air to be exhaled and watch for the chest to fall. Repeat 12 times per minute (once every 5 seconds).
• Mouth-to-nose resuscitation may be necessary if the mouth cannot be opened or is seriously injured. The technique is the same as mouth-to-mouth, except that the mouth must be held closed and air blown into the victim's nose. The mouth will need to be opened to allow the victim to exhale.

For infants:

• Use a combined mouth-to-mouth and mouth-to-nose resuscitation. The technique is the same as for an adult, but with breaths delivered at a slightly higher rate&#151about 20 per minute (once every 3 seconds).

IF YOU'RE HEADING FOR THE HOSPITAL...

What to Expect While You're There

You may encounter the following procedures and equipment.

• Taking Vital Signs: These include temperature, pulse, blood pressure, and respiration. A stethoscope is used to listen to the heart and lungs. Blood pressure is taken by wrapping a cuff around the arm. These tests may be performed hourly.
• Oxygen: If the victim is breathing on his own, oxygen will be given by either a mask or nasal prongs. If he is not breathing, he'll be hooked up to a mechanical ventilator.
• IV: A tube placed in the vein for giving medications, such as antibiotics, pain medications, or liquids. It will either be capped or have tubing connected to it.
• X-ray: If the victim has suffered physical trauma, x-rays will be taken to check for injuries.
• CT Scan: Computerized axial tomography, a type of x-ray also know as a CAT scan or CT scan, may be used to further evaluate internal injuries.
• MRI: Magnetic resonance imaging can also be used to assess the damage. For these pictures, the victim will be placed on a narrow bed and slid into a scanner.
• Medicine: The victim may be given several types of medication to prevent airway spasms, reduce lung inflammation, and treat infection.
• Hyperbaric Chamber: This is a machine that provides oxygen at a much higher pressure than normal atmospheric conditions. Some chambers accommodate one person and others can accommodate as many as 10 people. In a single-person chamber, a narrow bed carries the patient into the device, much like an MRI scanner. In a multi-person chamber, the patient receives oxygen through a mask, hood, or tube connected to the wall.
• Pulse Oximeter: This is a clip placed on the ear, finger, or toe and connected to a machine that measures the level of oxygen in the blood.
• Neuro Signs: To check for possible brain damage, the doctor will assess the responsiveness of the patient's eyes, test his memory, and see how easily he can be awakened.
• Blood: Samples are taken from a vein in the hand or the bend in the elbow to be used for testing. The level of oxygen dissolved in the blood will also be evaluated, so additional samples may be drawn from the wrist, elbow, or groin.

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