▷ FIRST AID: for ASPHYXIA. How TO ADMINISTER? TREATMENT and PROCEDURES

Among the causes of asphyxia we have mechanical causes, which is when some obstacle prevents the air from reaching the pulmonary alveoli. Other times asphyxia is due to toxic gases or rarefaction of air.

In other cases the cause may act on the nervous centers, depressing the respiratory center (electric shock, toxic substances: morphine, barbiturates, etc.)

Mechanical causes of asphyxia include either a foreign body lodged in the larynx or trachea, or edema or false membrane formation of these passages.

Other times, it is an external compression of the trachea or larynx, as in the case of strangulation or hanging.

More frequently, asphyxia is observed by submersion or drowning. And even certain diseases can cause asphyxia, such as asthma, bronchopneumonia or acute pulmonary edema.

Accidents caused by confined air are not really due to excess carbon dioxide or lack of oxygen, but to the loss of the cooling power of the environment on the body, due to the increase in two factors: temperature and humidity.

An example of these toxic gases is carbon monoxide, as well as carbon dioxide, hydrogen sulphide and sewage gases.

In times of war there is also the constant threat of venous gases.

It can also happen that climbing very high mountains can, in people with some disease or predisposing condition, cause asphyxiation. Even in a healthy person, high altitude in an aircraft without equipment that provides oxygen or higher pressure, or when this fails, can cause asphyxiation.

Electric shock and certain poisonings that can cause depression of the respiratory center, morphine, barbiturates and general anesthetics. Certain diseases of the nervous system can also paralyze the respiratory center or the nerves that innervate the respiratory muscles.

The same lack of oxygen produced by any other cause of asphyxia is capable of paralyzing the respiratory center.

One of the most common symptoms of asphyxia is a bluish skin color, or cyanosis. When it occurs in a person who is very anemic or in a state of shock, the skin color may be pale grayish.

The symptoms of asphyxia differ according to the way it occurs. For example, when asphyxia is rapid and the respiratory center is normal, three periods can be distinguished:

    First period (of stimulation of the respiratory center)

Breathing becomes deeper and faster, most noticeable during inspiration. Blood pressure increases and palpitations occur. Peripheral vessels dilate and the pupils contract.

    Second period (of cyanosis)

There is a marked bluish color to the skin. Inspiration becomes shallower and expiration more prolonged and intense. Coma usually occurs.

    Third period (of convulsions)

There is involuntary expulsion of urine and feces, due to relaxation of the sphincters and, sometimes, convulsions. The pupil dilates and collapse (extreme prostration and depression) occurs. If the airway is completely occluded, death occurs after 6 to 8 minutes.

When asphyxia occurs gradually, dyspnea (difficult breathing) and cyanosis are seen, followed later by torpor and finally coma and collapse without convulsions.

ASPHYXIA BY DROWNING

Asphyxia by drowning occurs when a large amount of liquid, usually water, enters a person's airways, causing them to lose oxygen. Immersion asphyxia can also occur, which occurs when a person is completely submerged in a body of water.

In other cases, a spasm of the larynx occurs, which also prevents water from entering the trachea. If this spasm persists after the drowning person has been removed from the water, it can prevent artificial respiration from being effective.

When drowning, a person begins by stopping breathing. Sometimes at the end, almost unconscious, they can make some respiratory movements that bring water into the lungs. In many cases, the lack of oxygen causes paralysis of the respiratory center in the medulla oblongata.

If the drowned person is pulled out of the water relatively quickly, he or she has a bluish complexion, especially on the face, and a congested appearance. However, when the person has been underwater for a long time, the symptoms of drowning are pale skin. He or she is not breathing and the pulse, if present, is very weak and rapid.

When there is no pulse and no heartbeat is felt, the drowned person has every appearance of being dead. This death may be real and no treatment will be able to resuscitate the drowned person. However, it may also be a state of apparent death, in which there is a possibility of exciting the vital centers of the bulb, which are already paralyzed.

In general, it is difficult for apparent death not to have become real after half an hour of immersion, but even if more time has passed, it is advisable to try to revive the person.

First aid for asphyxia by drowning is:

• If you notice that the mouth or throat is obstructing the free passage of air, wipe it with a handkerchief.

• If you have false teeth, remove them.

• If the person has drowned in fresh water, do not try to remove water from the lungs.

• If the person has drowned in salt water, quickly place the drowned person face down, with the head and chest lower than the rest of the body, as this may allow the water to escape. Do not waste too much time on this operation.

The collaboration of several people must be obtained to take turns in artificial respiration maneuvers, unless a mechanical device is available.

Immediately perform artificial respiration using the "mouth-to-mouth" method.