exchange air. This makes it hard to get enough oxygen to the cells or remove carbon dioxide and waste products from the blood.
Treatment
The emergency treatment of COPD also centers on relief of breathing symptoms. Often, the stress of the situation can add to this patient’s distress. Attempt to calm the patient with assurance you are there to help. Notify the PIC, Aircare Access and administer oxygen. Also, allow the patient to assume what is called the “position of comfort.” This position, usually sitting upright while leaning slightly forward can make it easier for the patient to breathe.
AIRWAY
OBSTRUCTIONS Choking is caused when a piece of food or other foreign object gets stuck in the upper airway. In the back of the throat, there are 2 openings. The first opening is the food tube (esophagus). The esophagus leads to the stomach and is the route for nutrition. The second opening is the air tube, called the trachea. The trachea leads to the lungs. When you swallow, the trachea is covered by the epiglottis, which prevents food from entering the lungs.
The trachea splits into the left and right mainstem bronchi. These lead to the left and right lungs, respectively. The bronchi branch into increasingly smaller tubes as they spread throughout the lungs. If an object ends up in the airway, it will become stuck as the airway narrows. Larger objects usually get stuck just inside the trachea at the vocal cords.
Adults most often choke on food that is not chewed properly. Talking or laughing while eating may also cause a piece of food to go “down the wrong pipe.” Normal swallowing mechanisms may be affected if a person has been drinking alcohol. In older adults, risk factors for choking include advancing age, poorly fitting dental work and the effects of alcohol consumption.
Many times a person who is choking while eating is thought to be having a heart attack, when in fact, the person is choking. Although choking has nothing to do with a heart attack; the term “cafe coronary” is still commonly used to refer to someone choking on food.
Children choke on a variety of objects and food. Respiratory System 29
Children also put small objects in their mouths, which may become lodged in their throat. Toys, rocks and other objects have all been the cause of choking incidents. Many household items can be a choking hazard.
Most people don’t realize that in the U.S. alone, more than 3,000 people die each year as a result of choking! You need to ask yourself if you would be able to recognize if a family member or friend started to choke. Would you know what to do?
Listed are common choking situations:
• Trying to swallow large pieces of poorly chewed food.
• Eating too fast.
• Drinking alcohol before or during meals. Alcohol can act to dull the nerves that assist in swallowing.
• Wearing dentures. Dentures make it difficult to sense whether food is fully chewed before it is swallowed.
• Eating while talking or laughing.
• Walking, playing or running with food or objects in the mouth.
Choking is among the true medical emergencies that require fast, appropriate action by anyone who is available. When in the middle of a flight, emergency personnel may not arrive in time to save the choking person’s life. You can make a difference. In this case, minutes really do mean life!
PARTIAL AIRWAY OBSTRUCTION
In a partial airway obstruction, some air will still be getting through to the lungs. The treatment for this is the same in American Heart Association and European Resuscitation Council guidelines. First, ask the person, “Are you choking?” If the patient can answer or air is obviously getting into the lungs, do not treat the patient. Simply give encouragement to cough and expel this partial obstruction. Never slap a patient on the back. Although this may work in the movies, it can turn a partial blockage into a complete one! The obstruction will either come out on its own or progress to a complete blockage.
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