Respiratory Emergencies Toolbox Talk

Respiratory emergencies can happen when a worker cannot breathe normally because of dust, fumes, smoke, chemical exposure, asthma, allergic reaction, heat stress, confined space hazards, or medical conditions. Breathing trouble can get worse fast, and a worker may panic, collapse, or stop breathing if help is delayed.

This talk focuses on recognizing breathing emergencies, getting help quickly, moving workers away from hazards when safe, and supporting trained first aid and CPR responders until emergency services arrive.

Why This Matters

• Breathing problems can become life-threatening within minutes.
• Dust, vapors, gases, smoke, and low-oxygen areas can affect more than one worker at the same time.
• Workers may downplay shortness of breath, chest tightness, dizziness, or coughing so they can keep working.
• Fast action helps prevent collapse, cardiac arrest, or a failed rescue attempt.
• Clear reporting helps emergency responders understand the exposure, location, and hazards before they arrive.

Common Hazards

• Silica dust, drywall dust, insulation fibers, concrete cutting dust, welding fumes, smoke, and exhaust.
• Chemical vapors from solvents, coatings, adhesives, fuels, cleaners, acids, caustics, or mixed products.
• Confined spaces, basements, tanks, pits, trenches, manholes, or enclosed rooms with poor ventilation.
• Generators, heaters, compressors, forklifts, or equipment exhaust running near doors, intakes, or enclosed areas.
• Allergic reactions from stings, bites, foods, chemicals, latex, or environmental exposure.
• Workers using the wrong respirator, a damaged respirator, or no respiratory protection where it is required.
• A worker entering to help someone who collapsed in a low-oxygen, toxic, or unknown atmosphere and becoming a second victim.

Safety Checklist

Before Work Begins

• Identify tasks that may create dust, fumes, smoke, vapors, gases, or low-oxygen conditions.
• Review required ventilation, respiratory protection, air monitoring, permits, and rescue plans for the work area.
• Locate the nearest first aid kit, AED, phone, radio, emergency contact list, and clean air route.
• Know who on the crew is trained in first aid, CPR, AED use, and site-specific rescue procedures.
• Confirm workers know to report coughing, wheezing, shortness of breath, chest tightness, dizziness, or throat irritation right away.

During Work

• Stop work if a worker has trouble breathing, cannot speak in full sentences, is wheezing, gasping, confused, blue or gray, or collapses.
• Call emergency services right away for serious breathing trouble, suspected toxic exposure, collapse, or loss of consciousness.
• Move the worker to fresh air only if it can be done safely without exposing rescuers.
• Do not enter a confined space, pit, tank, trench, or unknown atmosphere to rescue someone unless trained, equipped, and authorized.
• Have trained workers provide first aid, CPR, rescue breathing, or AED use within their training.
• Keep the worker calm, seated upright if breathing is easier that way, and away from dust, fumes, smoke, and equipment exhaust.
• Give responders clear details about the exposure, chemical name if known, symptoms, location, ventilation, and any workers still in the area.

Crew Talking Points

• What work today could create dust, fumes, smoke, vapors, gases, or poor air quality?
• Where is the nearest fresh air route, first aid kit, AED, phone, radio, and emergency contact list?
• Who on this crew is trained in first aid, CPR, AED use, or rescue procedures?
• What areas require ventilation, respiratory protection, air monitoring, or a permit before entry?
• What symptoms mean we stop work and call emergency services right away?
• Speak up if ventilation is poor, respirators are not right for the task, air monitoring is missing, or anyone is having breathing symptoms.

Stop Work If

• A worker has trouble breathing, chest tightness, severe coughing, wheezing, confusion, blue or gray skin, or collapses.
• Dust, fumes, smoke, vapors, gases, or exhaust are building up in the work area.
• A worker is down in a confined space, pit, trench, tank, manhole, or unknown atmosphere.
• Ventilation, air monitoring, respiratory protection, or rescue equipment is missing, damaged, or not working.
• The crew does not know what the exposure is or whether the atmosphere is safe.

Final Reminder

Breathing trouble is an emergency. Stop work, get help, move to fresh air only when safe, and never rush into an unknown atmosphere without proper training and equipment.