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A person who has difficulty breathing is having trouble moving air in or out of the lungs. This can be the result of an airway obstruction, disease, severe allergic reaction, injury, or other medical condition.

What are the signs and symptoms of the injury?

• wheezing, which is a squeaking sound made when the person breathes out
• shortness of breath, or the feeling of not getting enough air
• confusion
• weakness
• dizziness, or light-headedness
• pale or bluish lips and fingernails
• gurgling sounds in the chest
• cough
• anxiety
• person clutching his or her throat or chest
• coughing up blood
• coughing up frothy, white material
• tightness across the chest associated with breathing

What are the causes and risks of the injury?

• emphysema, a chronic lung disease in which the air sacs are destroyed, seen mostly in smokers
• chronic bronchitis, a chronic lung disease also seen in smokers, that is marked by persistent coughing up of sputum from the lungs
• asthma, a lung disease in which the overly-sensitive airways become narrowed in response to various triggers

• crush injuries to the chest or airways, such as those resulting from a motor vehicle crash or a sports injury
• pneumothorax, or collapsed lung
• congestive heart failure, a condition in which the weakened heart is unable to pump enough blood to body organs and the lungs fill up with fluid
• coronary or valvular heart disease
• adjustment to a high altitude
• an obstruction in the airway, as in the case of a person who is choking

What can be done to prevent the injury?

• avoiding smoking
• following sports safety guidelines for children, adolescents, and adults
• working closely with the healthcare provider to control diseases and conditions such as congestive heart failure and asthma
• wearing seat belts in a moving vehicle
• limiting exertion when going to a higher altitude

How is the injury recognized?

Diseases such as emphysema, chronic bronchitis, and asthma are diagnosed with pulmonary function tests and chest X-rays.

Heart disease and congestive heart failure are diagnosed with chest X-rays, blood tests, an ECG or electrocardiogram, and a physical examination.

A collapsed lung is diagnosed with a chest X-ray. Injuries to the chest are diagnosed by chest X-ray and by physical examination.

What are the treatments for the injury?

• Assist the person in using oxygen or an inhaler for lung disease, if appropriate.
• Check for signs of circulation, such as normal breathing, coughing, or movement in response to stimulation.
• Contact the emergency medical system immediately (call 911).
• Start cardiopulmonary resuscitation, or CPR, if the person stops breathing or the heart stops beating. Remember "Call, Blow, Pump".
• Check the victim for unresponsiveness. If there is no response, Call or have someone call 911 and return to the victim. In most locations the emergency dispatcher can assist you with CPR instructions.
• Tilt the head back and listen for breathing. If not breathing normally, pinch nose and cover the mouth with yours and Blow until you see the chest rise. Give 2 breaths. Each breath should take 1 second.
• If the victim is still not breathing normally, coughing or moving, begin chest compressions. Push down on the chest 1 and 1/2 to 2 inches 30 times, right between the nipples. Pump at the rate of 100/minute, faster than once per second.
• Stay with the person until medical assistance arrives.
• Assume there may be other injuries if wounds are severe enough to injure the chest. Do not allow the person to move around. Try to firmly support the injured area without moving the head, neck, or spine. In some instances, to help a person breathe, the head and back may need to be moved. Maintaining an open airway and keeping the person breathing is most important.
• If bubbles appear in the wound, there is probably an injury to the lung. Bandage the wound at once.
• Bandage the wound with something that will not allow air into the wound if bubbles appear or there is a "sucking" sound. Plastic wrap or a plastic bag will work. Air needs to escape through the wound, so leave one corner open. The best way to seal the bandage is with petroleum jelly around three sides, leaving one corner free.
• Do not let the person eat or drink anything.
• Try not to move the person, and obtain medical assistance as soon as possible.

What are the side effects of the treatments?

If the person has suffered a major injury, treating his or her breathing problem may cause an injury to some other organ. Helping the person breath may cause further injuries to the neck or back. However, maintaining an open airway and keeping the person breathing is most important.

What happens after treatment for the injury?

A person who has difficulty breathing should carry a medical identification tag listing his or her existing medical conditions. He or she should keep a medication list easily available. Any medications required for immediate help should be carried at all times.