Breathing difficulties - first aid
Breathing difficulties can range from:
- Being short of breath
- Being unable to take a deep breath and gasping for air
- Feeling like you are not getting enough air
This article discusses first aid for someone who is having breathing problems.
Difficulty breathing - first aid; Dyspnea - first aid; Shortness of breath - first aid
Breathing difficulty is almost always a medical emergency (other than feeling slightly winded from normal activity, such as exercise).
There are many different causes for breathing problems. Common causes include:
- Anemia (low red blood cell count)
- Being at a high altitude
- Blood clot in the lung
- Chronic obstructive pulmonary disease (COPD), sometimes called emphysema or chronic bronchitis
- Collapsed lung (Pneumothorax)
- Heart attack
- Heart disease or heart failure
- Injury to the neck, chest wall, or lungs
- Life-threatening allergic reaction
- Lung cancer or cancer which has moved to the lungs
- Near drowning (fluid in the lungs)
- Pericardial effusion (fluid surrounding the heart and not allowing it to fill properly)
- Pleural effusion (fluid surrounding the lungs and compressing them)
- Respiratory infections, including pneumonia, acute bronchitis, whooping cough, croup, and others
A person with breathing difficulty may have:
- Bluish lips, fingers, and fingernails
- Chest moving in an unusual way as the person breathes (flail chest or paradoxical movement)
- Chest pain
- Confusion, lightheadedness, weakness, or sleepiness
- Gurgling, wheezing, or whistling sounds
- Muffled voice
- Need to sit up to breathe
- Swollen tongue
If someone is having breathing difficulty, immediately call 911 or your local emergency number, then:
- Check the person's airway, breathing, and pulse. If necessary, begin CPR.
- Loosen any tight clothing.
- Help the person use any prescribed medication (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.
- Give the person food or drink.
- Move the person if there has been a chest or airway injury, unless it is absolutely necessary.
- Place a pillow under the person's head. This can close the airway.
- Wait to see if the person's condition improves before getting medical help. Get help immediately.
When to Contact a Medical Professional
Call 911 or your local emergency number if you or someone else has difficulty breathing, especially if you notice:
- Blue lips, fingers, or fingernails
- Chest pain
- Coughing up large amounts of blood
- Dizziness or lightheadedness
- 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:
- 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.
Some things you can do to help prevent breathing problems:
- 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 epinephrine pen.
- If you have asthma or allergies, eliminate household allergy triggers like dust mites and mold.
- DO NOT smoke, and keep away from secondhand smoke. DO NOT 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 every few hours 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.
Cukor, J, Manno M. Pediatric respiratory emergencies: upper airway obstruction and infections. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 168.
Thomas SH, Goodloe, JM. Foreign bodies. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 60.
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: Elsevier Mosby; 2010:chap 106.
Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.