Respiratory Distress

Respiratory distress, or difficulty breathing, is evidenced by signs and symptoms such as shortness of breath, gasping for breath,hyperventilation(breathing that is faster and shallower than normal), or breathing that is uncomfortable or painful. Respiratory distress can lead to respiratory arrest(absence of breathing).
Causes of Respiratory Distress
A number of different conditions can cause respiratory distress, including acute flare-ups of chronic respiratory conditions such as asthma or chronic obstructive pulmonary disease (COPD); lung and respiratory tract infections (such as pneumonia or bronchitis); severe allergic reactions (anaphylaxis); heart conditions (such as a heart attack or heart failure); trauma; poisoning; drug overdose; electrocution; and mental health conditions (such as panic disorder).

Signs and Symptoms of Respiratory Distress

A person who is experiencing respiratory distress is,understandably, often very frightened. The person may feel like he or she cannot get enough air and may gasp for breath. Because the person is struggling to breathe,speaking in complete sentences may be difficult. You might hear wheezing, gurgling or high-pitched noises as the person tries to breathe. You may also notice that the person’s breathing is unusually slow or fast, unusually deep or shallow, or irregular. The person’s skin may feel moist or cool, and it may be pale, ashen (gray), bluish or flushed. Lack of oxygen can make the person feel dizzy or light-headed.

First Aid Care for Respiratory Distress

When a person is experiencing a breathing emergency, it is important to act at once. In some breathing emergencies, the oxygen supply to the body is greatly reduced, whereas in others the oxygen supply is cutoff entirely. If breathing stops or is restricted long enough, the person will become unresponsive, the heart will stop beating and body systems will quickly fail. Recognizing that a person is having trouble breathing and providing appropriate first aid care can save the person’s life.

You usually can identify a breathing problem by watching and listening to the person’s breathing and by asking the person how he or she feels. If a person is having trouble breathing, do not wait to see if the person’s condition improves. Call 9-1-1 or the designated emergency number and provide appropriate first aid care until help arrives:
If you know the cause of the respiratory distress (for example, an asthma attack or anaphylaxis) and the person carries medication used for the emergency treatment of the condition, offer to help the person take his other medication.

Encourage the person to sit down and lean forward. Many people find that this position helps to make breathing easier. Providing reassurance can reduce anxiety, which may also help to make breathing easier.

If the person is responsive, gather additional information by interviewing the person and performing ahead-to-toe check. Remember that a person having breathing problems may find it difficult to talk. Try phrasing your questions as “yes” or “no” questions so the person can nod or shake his or her head in response instead of making the effort to speak. You may also be able to ask bystanders what they know about the person’s condition.

Be prepared to give CPR and use an AED if the person becomes unresponsive and you are trained in these skills.


Many people have asthma, a chronic illness in which certain substances or conditions, called triggers, cause inflammation and narrowing of the airways, making breathing difficult. Common triggers include exercise, temperature extremes,allergies, air pollution, strong odors (such as perfume, cologne and scented cleaning products),respiratory infections, and stress or anxiety. The trigger causes inflammation and swelling, which causes the opening of the airways to become smaller and makes it harder for air to move in handout of the lungs. People who have asthma usually know what can trigger an attack and take measures to avoid these triggers.

A person who has been diagnosed with asthma may take two forms of medication.Long-term control medications are taken regularly, whether or not signs and symptoms of asthma are present. These medications help prevent asthma attacks by reducing inflammation and swelling and making the airways less sensitive to triggers.Quick-relief (rescue) medications are taken when the person is experiencing

an acute asthma attack. These medications work quickly to relax the muscles that tighten around the air ways, opening the airways right away so that the person can breathe more easily. Both long-term control medications and quick-relief (rescue) medications may be given through an inhaler, a nebulizer (Box 5-1)or orally.

Asthma Inhalers and Nebulizers

The most common way to take long-term control and quick-relief (rescue) medications is by inhaling them. Inhalation allows the medication to reach the airways faster and work quickly. There also are fewer side effects. Medications are inhaled using a metered dose inhaler (MDI), a dry powder inhaler (DPI) or a small-volume nebulizer.