# Treating SOB Off-duty



## Lifeguard (Aug 18, 2012)

I'm a lifeguard at an aquatics facility where heat waves are common and consequently breathing emergencies.  My training is minimal to say the least.

I'm starting a First Responder class in a couple days and after that the EMT program at my local JC so that I can deal with this type of stuff.

But our facility has no O2 and all we can do is call 911.  I would like some input on how to deal with this scenario without you stethoscopes, O2, BP cuffs, etc.

I've seen techniques where you have the pt put their hands on their head and take deep breaths, then proceed to gather info.

How would you do it without your equipment?


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## rwik123 (Aug 18, 2012)

Position of comfort and call 911. Your not in a position to treat as a lifeguard without formal training. Just comfort the patient until EMS arrives.


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## Handsome Robb (Aug 18, 2012)

Not much you can do other than what rwik said. 

Early recognition and activation of EMS. 

Without tools there isn't a whole lot anyone can do.

One thing you can do is don't pester them with questions, if they are working to breathe the last thing they need is you making them answer your questions. Ask friends and bystanders about the story, assure the patient you are there with them and aren't going anywhere but tell them you just want them to focus on their breathing.


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## Medic Tim (Aug 18, 2012)

Keep the pt calm. Help them find a position of comfort and call 911 is all you can really do.


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## Lifeguard (Aug 18, 2012)

What do you mean by a position of comfort? 

And what types of things can I say/ do to comfort them?  
e.g. Take three deep breaths with me, okay? 1 2 3


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## Shishkabob (Aug 18, 2012)

They're already getting 21% FiO2, very few people actually need more.  About the same amount of people complaining about SOB also need any sort of medical intervention.   Don't fret yourself.  Most people in that situation has pre-existing medical conditions and have dealt with their current issue before and usually have the 'know-how', if not the tools, to do what they need to.



I'm off duty and no one knows I'm a Paramedic, and thus I'm keeping to myself.


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## Aidey (Aug 18, 2012)

I'm failing to see the connection between heat waves and "breathing emergencies", can you explain better? Are these people who are overexerting themselves?


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## Handsome Robb (Aug 18, 2012)

Linuss said:


> I'm off duty and no one knows I'm a Paramedic, and thus I'm keeping to myself.



This. 

When I worked as a beach guard I'd ID myself as a Lifeguard and EMT but I was working in the capacity as one, plus people tend to trust you a bit more than just your standard lifeguard. 

As far as position of comfort, however they want to sit. True breathers generally like to sit upright as they can or in a tripod position. Think seated and leaning forward with your hands on your knees. 

Another thing is get them the heck out of the sun. Either inside into the air conditioning or at least into some shade. Recruit one of the cute girl guards to be an umbrella girl if you have to. Don't crowd them though, if they feel claustrophobic it may make the situation worse. 

I'd advise against of coaching them on their breathing unless they are hyperventilating and then you can attempt to coach them into slowing their breathing.


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## Akulahawk (Aug 19, 2012)

NVRob said:


> This.
> 
> When I worked as a beach guard I'd ID myself as a Lifeguard and EMT but I was working in the capacity as one, plus people tend to trust you a bit more than just your standard lifeguard.
> 
> ...


I wouldn't advise most people to coach someone on their breathing. Allowing the patient to find their own position of comfort is good as is finding a cool place. As a lifeguard, you wouldn't likely get much (if any) education about respiratory emergencies anyway, so just do position of comfort and get EMS on the way. 

In the past, I have coached someone's breathing rate down to normal, but that was a very specific circumstance and I was reasonably certain it would work, and if it didn't, the problem would self-correct anyway.


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## Shishkabob (Aug 19, 2012)

Exactly.  The only true coaching to be done is with hyperventilation secondary to anxiety, and in the end if they don't follow it, they'll pass out and it will self-correct, issue resolved.  

For someone like an asthmatic or CHFer, "mind over body" doesn't work.


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## Handsome Robb (Aug 19, 2012)

Linuss said:


> Exactly.  The only true coaching to be done is with hyperventilation secondary to anxiety, and in the end if they don't follow it, they'll pass out and it will self-correct, issue resolved.
> 
> For someone like an asthmatic or CHFer, "mind over body" doesn't work.



Sorry should have been more specific. 

As far as life guard training goes I've got a pretty good idea of what it involves seeing as I was a lifeguard supervisor as well as an instructor at my last gig. 

OP even if you have oxygen it's not an end-all, fix-all like the lower level courses would have you believe.


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## Akulahawk (Aug 20, 2012)

NVRob said:


> Sorry should have been more specific.
> 
> As far as life guard training goes I've got a pretty good idea of what it involves seeing as I was a lifeguard supervisor as well as an instructor at my last gig.
> 
> OP even if you have oxygen it's not an end-all, fix-all like the lower level courses would have you believe.


As far as lifeguard training goes, I'm pretty familiar with it myself. I first took the course in 1992, as a full quarter-length class and again a few years later. I don't know what's different since then, but I doubt it includes anything substantially more than what I had learned back then. I would imagine that a good percentage of us EMS personnel do have lifeguard training somewhere in our past...


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