DOE: Ch. 7 Hyperventilation

Optimal pH of blood? What does it reach when respirations increase?

7.4, slightly alkaline. Increases to 7.5 or higher.

Symptoms of hyperventilation

Abnormally prolonged rapid and deep respirations. Heart palpitations, chest pains. Impaired problem-solving abilities, impaired motor coordination, balance and perceptual tasks. Lightheadedness, dizziness, impaired vision. Destabilization of brain can hasten seizures. Parasthesia of extremities. Chvostek's sign. Apprehension, diaphoresis (extreme sweating), trembling, fatigue, circumoral parasthesia (numbness around oral cavity), unconsciousness.

How to treat hyperventilation?

Increase blood carbon dioxide levels while addressing psychological factors that patient is experiencing. Remain calm and nonjudgemental.

Tetany

Manifests clinically as twitching of the muscles or spasms with sharp flexion of wrist and ankle joints. (AKA carpopedal spasms)

Should you use a paper bag for someone who is hyperventilating?

NO! Breathing into a bag can cause suffocation and cardiac arrest.

Should you give the patient oxygen if they are hyperventilating?

NO! Only emergency you don't need oxygen.

How do you tell the difference between pulmonary embolism episode and hyperventilation?

Pulmonary embolism will not exhibit spasms of the hands and ankles, nor will they experience tingling in mouth and fingers.

What if hyperventilation continues after working w/ patient?

Consider IM or oral administration of benzodiazepine to help alleviate symptoms. Lorazepam 1-2mg for ex.

What do levels of carbon dioxide go to when hyperventilation occurs?

Falls from normal 40mmHg to 30 or 25 mmHg in less than 30 sec.

EMS required?

If patient is suffering from a more serious conditions, such as pulmonary embolism.

Hyperventilation is charactered by lack of what? Which results in what?

Lack of carbon dioxide in the arterial blood system, resulting in respiratory alkalosis and cerebral vasoconstriction.

Hypocalcemia

Reduction in calcium levels in the blood stream. Progressive hyperventilation can cause this. Can lead to tetany. Can also be accompanied by parasthesia or numbness in extremities.

Respiratory alkalosis

increase in the pH of the circulating blood.

Symptoms of hyperventilation mimic what

many respiratory disorders, especially pulmonary embolism (blockage of pulmonary artery by some obstruction).

Steps to treating patient with hyperventilation?

1) Place patient in comfortable position (usually sitting up) 2) loosen any tight clothing around neck area. 3)Work with the patient to control the rate of respirations. Having patient count to 10 in one breath is helpful. As breathing through nose or pursed lips or having patient hold their breath as long as possible is also beneficial. 4)While attempting to control breathing, monitor BP, pulse and respirations. 5) if uneffective, have patient breathe through their hands in a "cup"

What groups is hyperventilation predominately found in?

Females aged 30-40. Also common in high altitudes, pregnant, aspirin toxicity, experience anxiety states, or take CNS-stimulatory drugs.

What occurs during hyperventilation?

Patient breathes faster and/or deeper than the metabolic needs of the body, eliminating more carbon dioxide than is being produced. May experience respirations 22-40/minute.

How does hyperventilation start?

Patient will begin to have deep, rapid respirations. Feel that they can't catch their breath and are suffocating (air hunger). Can magnify symptoms while experiencing this and feel more anxiety. Often they are unaware that they are overbreathing.

Hyperventilation is frequently a secondary complication of.....

a psychological event.

What does lowering of carbon dioxide cause?

causes vasoconstriction of the arteries and veins in many areas of the body, including the heart and brain. Leads to decreased cardiac output and reduce coronary blood flow.

Chvostek's sign

result of the hypocalcemia, an abnormal spasm of facial muscles elicited by light taps on facial nerve.