A number of conditions can cause sudden breathing
problems; your role as a first-aider is to remain calm, reassure the
casualty and to use your common sense about whether or not to call medical
If someone you are with has difficulty breathing, the problem is obvious.
The cause, however, may be less easy to determine.
Infections of the respiratory system, such as bronchitis or croup in
young children, cause coughing, wheezing and distressed breathing. Allergic
reactions like hay fever affect the breathing specifically, while
anaphylactic shock is a fast-acting collapse of basic functions, including
breathing, which is brought on by allergy to an insect sting or a particular
food or drug. Chest injury can cause a collapsed lung that makes breathing
difficult. Psychological stress may create sudden problems like
hyperventilation and asthma.
During an asthma attack the muscles of the air passages go into spasm and
constrict, making breathing - especially breathing out - very hard. An
attack can be brought on by an allergy or by nervous tension but there is
often no obvious cause. Sudden attacks at night are particularly common.
Regular sufferers know how to cope and usually carry a puffer aerosol
which contains a drug to dilate the air passages.
Signs to look for are difficulty in breathing, with very prolonged
breathing out, often accompanied by wheezing. A sufferer may be upset and
anxious and able to speak only in whispers. The skin may turn slightly blue.
This condition is easy to recognize as there will be unnaturally fast, deep
breathing - hyperventilation. It is often the result of acute anxiety and
may occur with a panic attack or hysteria. Shock or a severe fright can also
bring it on.
Breathing in this way produces chemical changes in the blood that result
in faintness, dizziness, trembling, or tingling in the hands, Twitching or
cramp in the face, hands and feet can also occur.
An attack of croup causes severe breathing difficulty in very young children
and is the result of inflammation in the windpipe and larynx. It generally
occurs at night and can be alarming, but rarely causes any lasting harm.
Along with the distressed breathing there may be a short, barking cough,
a crowing or whistling noise when inhaling and a blue tinge to the skin.
If the attack persists, and there is a fever or high temperature, seek
medical advice. It may be a rare condition (but unlikely in a child who has
been fully vaccinated) in which the epiglottis - a flap-like structure in
the throat - becomes swollen and blocks the airway.