First-Aid: First-Aid for Asphyxia (Suffocation)

It is deficiency of oxygen and increase in carbon dioxide in the blood and tissues. It occurs due to a failure of exchange of oxygen and carbon dioxide between the air and pulmonary capillaries.

□ CAUSES OF ASPHYXIA

Airway obstruction due to

• Foreign body in the airway causing choking.
• Spasm of respiratory muscles as in tetanus.
• Drowning.
• Suffocation under bed.
• Suffocation due to a plastic bag over the head.
• Strangulation, hanging or throttling.
• Bronchospasm, e.g. bronchial asthma.
• Electric shock.

Lack of oxygen in the air inspired due to

• High altitudes with low atmospheric pressure.
• Fire : inhalation of smoke.
• Gas leaks : inhalation of gas (Coal gas, automobile exhaust fumes etc.)

EFFECTS OF ASPHYXIA

1. First stage

• Respiratory rate increases.
• Breaths become shorter and noisy.
• Chest movements of breathing are reversed. The chest wall gets sucked in instead of moving out when the victim breathes in.
• The nostrils flare during breathing.
• Neck veins get distended.
• Cyanosis develops. The face, lips, nails, fingers, and toes turn blue.
• Pulse becomes faster and feeble.

2. Second stage

• Consciousness is lost.
• Frothing occurs at the mouth and nose.
• Convulsions may occur.
• Urine and feces are passed involuntarily.
• Death may occur if not treated in time.

First-aid

1. Remove the cause, if possible.
2. Place the victim on his back.
3. Clear the airway and provide warmth.
4. Loosen his collar.
5. Put a finger in the mouth and throat and remove a foreign body if present.
6. Remove denture, if present.
7. Hold the angle of the jaw forward and tilt the head backwards. This opens the airway.
8. Give artificial ventilation and external cardiac massage, if required.
9. Send him to a hospital after he settles down.

□ DROWNING

A person who does not know how to swim can drown accidentally if he falls into water. It may also be homicidal. Persons who know how to swim may drown too, if under the influence of alcohol, or if there is head injury at the time of the fall and the person becomes unconscious. Water enters the airway so that asphyxia develops. A little amount of water enters the lungs too, and damages them.

Rescuing a drowning person

1. Do not swim out to rescue him unless you have been trained as a lifeguard.
2. If the water is not too deep, wade through it to get him out of it. Do not wade out if the nature of the bottom of the water is not known, because you may fall into a hole or a bed of quicksand.
3. If the victim is near the shoreline, extend a long stick or pole towards him. Pull him in when he grabs it.
4. If he cannot be reached by a stick, throw him a lifebuoy or a plank that he can float on. Tel! him to keep his face above water.
5. Use a boat to reach the victim, if one is available easily. Tell him to climb in when you reach him. If he cannot do that ask him to hold onto the boat while you row him back to land.

First-aid

1. Put the victim on the ground, face down.
2. Clear the airway of any foreign body.
3. Elevate the middle part of his body with your hands under him to make any water in the lungs to drain out.
4. Do not try to force the water out from the stomach.
5. Give artificial ventilation until normal breathing is restored.
6. Remove wet clothes and put on dry clothes. Keep him warm with blankets and hot water bags.
7. Do not allow him to sit up.
8. Give him hot tea or coffee to drink.
9. Send him to a hospital as soon as possible.

□ STRANGULTION

It includes hanging, strangling, and throttling. External pressure is exerted on the neck, which causes obstruction of the airway and cuts off flow of air to the lungs. Hanging and strangling may be accidental or homicidal. Throttling is homicidal.

□ STRANGULATION

Type Features

Hanging – Suspension of the body by a noose around the neck.
Strangling – Constriction around the neck.
Throttling – Squeezing the throat.

The condition is diagnosed by the following features.

1. The constricting article may be present around the victim’s neck.
2. If it has been removed, its marks are found on the neck.
3. There are features of asphyxia.

Tiny red spots may be seen on the face or the whites of the eyes.

First aid

1. Remove any constriction present around the victim’s neck. Support the body if you are cutting a noose around his neck while he is still hanging.
2. Place him flat on the ground, face up.
3. If he is not breathing, give artificial respiration.
4. Shift him to hospital soon and inform police.

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