Rescue breaths and abdominal thrusts save lives during breathing emergencies.
| WHAT COACHES SHOULD KNOW |
- In dealing with breathing emergencies, a coach or responder should activate the Emergency Action Plan and follow the emergency action steps, Check- Call-Care. Check the scene for safety and Check the athlete, Call 9-1-1 or the local emergency number when needed, and Care for the player until EMS personnel arrive.
- If a player is conscious and choking, a coach or teammate should try to dislodge the object by performing abdominal thrusts until the object is removed.
- In dealing with respiratory arrest, a coach or responder provides care by performing rescue breathing.
- Coaches need to make sure asthma sufferers have their medication, which allows them to breathe easier.
- To learn how to handle breathing and other life-threatening emergencies, contact your local American Red Cross and enroll in a first aid, CPR, and automated external defibrillator course.
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| To Perform Abdominal Thrusts |
- Stand behind the injured player and wrap your arms around his or her waist.
- Make a fist with one hand and place the thumb side against the middle of the injured player's abdomen just above the navel and well below the lower tip of the breastbone.
- Grab your fist with your other hand and give quick upward thrusts into the abdomen.
- Repeat these thrusts until the object is dislodged or the injured player becomes unconscious.
- If the player is unconscious, look for an object in the airway and, if found, remove it. If found or not found, continue rescue breathing.
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Competing in a football game is an intense time for a player eager to win. Players may be overly anxious and aggressive. While feeling this way, some athletes may want to make a big play at all costs and may not be mindful of safety hazards. For example, a player may tackle an opponent with such force that it knocks the wind out of that person or causes respiratory arrest. Coaches need to act immediately to deal with breathing complications and other respiratory emergencies that may occur.
When responding to an emergency, a coach or responder should activate the Emergency Action Plan and follow the emergency action steps, Check-Call- Care. Check the scene for safety and check the athlete, Call 9-1-1 or the local emergency number when needed, and Care for the player until EMS personnel arrive. Respiratory arrest can be the result of an injury to a player or an illness. If the player is not breathing, the responder should provide care by giving rescue breaths immediately.
| Signals Of Stopped Breathing Include: |
- Cannot see, feel, or hear breaths.
- Chest does not move.
- Skin appears ashen, bluish, or pale.
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| If The Athlete Is Not Breathing: |
- Remove the facemask.
- Carefully tilt the head back trying to maintain a neutral neck position (neck in line with shoulders) and lift the chin. If an injury is suspected, do not lift the chin, rather pull jaw forward making all efforts to stabilize the neck. By employing this jaw thrust maneuver you will have done everything to keep the neck in a neutral position.
- Look, listen, and feel for breathing for about five seconds.
- Be alert to special circumstances such as back or neck injury.
- Using a breathing barrier, make a seal over the player's mouth and nose, then give 2 slow breaths. Each breath should make the player's chest gently rise and fall.
- Give two slow breaths until the chest gently rises. If the breath does not go in, check for airway obstruction.
- Check for signs of circulation for no more than 10 seconds. If signs of circulation are present, and the athlete is not breathing, continue rescue breathing. If signs of circulation are not present, begin CPR.
- The only instance in which an athlete's helmet and shoulder pads should be removed is when a medical authority believes it is necessary for the care of the athlete or if the equipment interferes with the rescuer's ability to provide required CPR. Remove the helmet by opening the straps and pulling directly backward. Obtain available assistance to minimize neck movement and to maintain the neck in a neutral position (level with the height of the shoulders). After the helmet is removed, keep the neck in a neutral position by manual support or placing towels or clothing under the head. If the shoulder pads must be manipulated to provide chest compression, do so with minimal required movement. Maintain maximum control of the neck and open and move the shoulder pads only as much as is required to provide effective chest compression.
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If The Airway Is Obstructed:
Another breathing difficulty is airway obstruction, which is caused when an object blocks the airway. A coach or teammate should try to dislodge the object by performing abdominal thrusts, also known as the Heimlich maneuver, until the object is removed. To perform abdominal thrusts, stand behind the injured player and wrap your arms around his or her waist. Make a fist with one hand and place the thumb side against the middle of the injured player's abdomen just above the navel and well below the lower tip of the breastbone. Grab your fist with your other hand and give quick upward thrusts into the abdomen. Repeat these thrusts until the object is dislodged or the injured player becomes unconscious.
| If The Injured Player With An Obstructed Airway Becomes Unconscious: |
- Remove the facemask.
- With the athlete positioned on his back, carefully tilt the head back, trying to maintain a neutral neck position (neck in line with shoulders), lift the chin. If an injury is suspected, do not lift the chin, rather pull jaw forward making all efforts to stabilize the neck. By employing this jaw thrust maneuver you will have done everything to keep neck in a neutral position.
- Using a breathing barrier, make a seal over the player's mouth and nose, then give 2 slow breaths. Each breath should make the player's chest gently rise and fall.
- If the athlete's chest does not rise as you attempt to give breaths, retilt the head or pull the jaw forward if a neck injury is suspected and try rescue breaths.
- If the chest does not rise, perform abdominal thrusts with the unconscious player lying flat. Place the heel of one hand on the middle of the abdomen just above the navel. Place the other hand on top of the first. Give five quick upward thrusts. To learn this skill, please enroll in an American Red cross CPR for the Professional Rescuer course.
- Open the mouth and observe for an object causing obstruction. If this object is found, remove it. If an object is not found, or is not present, resume giving two slow breaths. If the breaths go in and the athlete has a pulse, resume rescue breathing. If the athlete shows no signs of circulation, begin full CPR (see page 29). If the breath does not go in, repeat two slow breaths and then abdominal thrusts. Open the mouth again and look for an object. If an object is seen, remove it and resume rescue breathing. Maintain that sequence of two slow breaths two times, followed by abdominal thrusts and opening the mouth to look for an object until Emergency Medical Staff arrives.
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Other Breathing Difficulties:
Not all breathing difficulties are the result of an accident or airway obstruction. Some players have medical conditions, such as asthma, that cause breathing problems. Overexertion can also trigger a player to hyperventilate. In dealing with asthma and hyperventilation, simple measures return a player's breathing to normal. Asthma sufferers generally need their medication, which reverses the muscle spasm that narrows their air passage and allows them to breathe easier. Coaches have to pay close attention to players with this condition and make sure parents have inhalers available for their children at all times.
Unlike asthma, hyperventilation is generally the result of emotional stress that causes the breathing to become rapid and shallow. Coaches treating players who are hyperventilating need to calm the person down. Easing stress will generally help breathing return to normal. A player who has "had the wind knocked out of him" should be treated like the player who is hyperventilating. A player in this situation may not know what is happening to him and could begin to panic and hyperventilate. It is important to allow the player to rest and attempt to ease his stress so that his breathing may return to normal. The old practice of pulling on the athlete's belt and lifting his back should not be used.
Respiratory emergencies may occur to an athlete on the field as easily as a sprained ankle. When this happens, players and coaches need to know the drill. The team and the coaches should stay calm during intense situations and know how to provide appropriate care, such as abdominal thrusts and rescue breathing. Those simple actions can save lives.
MORE READING
American National Red Cross. (2001). Breathing emergencies. Emergency response. San Bruno, CA: StayWell.
American National Red Cross and the United States Olympic Committee. (1997). Sport safety training handbook.San Bruno, CA: StayWell.
The evaluation of any athlete, whether as a part of health evaluations prior to activity or as a diagnosis of an injury as the consequence of sports activities, is specific to that individual and the history and current state of the individual presented. Advice, diagnosis and treatment is individualized according to numerous factors, including patient health and age information, medical history and symptoms. All athletes should be cleared by a physician or other appropriate medical professional before engaging in physical activities and, after injury, diagnosis and treatment, for return to play.