WK1 - Lecture 6 - Student - Hyperventilation - Su24 PDF

DH 410 – Emergencies in Dental Practice Lecture 6: Hyperventilation Objectives Recognize signs and symptoms of hyperventilation Understand and explain steps in emergency preparation and care for a patient experiencing hyperventilation Hyperventilation  Hyperventilation A c...

DH 410 – Emergencies in Dental Practice Lecture 6: Hyperventilation Objectives Recognize signs and symptoms of hyperventilation Understand and explain steps in emergency preparation and care for a patient experiencing hyperventilation Hyperventilation  Hyperventilation A condition where rapid, deep breathing occurs  Faster and deeper than metabolic needs of the body  Eliminating more carbon dioxide than is produced Normal adult respiration rate: 12- 20 RPM Hyperventilation rate: 22 – 40 RPM Affects 6–15% of population More common in females age 30 – 40  Hyperventilation Most Common: ◦Exposed to high altitudes ◦Pregnant women ◦CNS stimulants ◦Aspirin toxicity ◦Extremely anxious  Hyperventilation Pathology: ◦ Rapid or deep breathing ◦ Exhaling more carbon dioxide (CO2) than body can produce ◦ Leads to low level of CO2 in blood ◦ Lack of CO2 leads to respiratory alkalosis (increase in the pH of blood) ◦Hypocapnia ◦Decreases hemoglobin ability to release Oxygen  Hyperventilation Lack of CO2 leads to changes in blood pH Optimal pH 7.4 – slightly alkaline Hyperventilation – pH 7.5 or higher  Can take place in less than 30 seconds This minor change can have significant physiological effects  Vasoconstriction  Decreased blood to brain  Decreased cardiac output  LEADING TO SYNCOPE  Signs and Symptoms Common Symptoms: ◦ Abnormally prolonged rapid and deep respirations ◦ Heart palpitations, chest pain ◦ Lightheaded, dizzy ◦ Motor and problem-solving impairment ◦ Balance and perception impairment ◦ Seizures ◦ Tetany (twitching muscles) ◦ Extremity numbness ◦ Chvostek’s Signs – fascial muscle twitching  Signs and Symptoms Other symptoms: ◦ Apprehension ◦ Diaphoresis (profuse sweating) ◦ Trembling (muscle tremor) ◦ Fatigue ◦ Circumoral paresthesia (numbness around the mouth) ◦ Possible unconsciousness ◦ Feeling of suffocation (air hunger) Hyperventilation Can be secondary complication to psychological event  Representation of Panic Attack  Emotional state Gravity (seriousness) often underestimated  Symptoms mimic pulmonary embolism (sans hand/ankle spasms and mouth/finger numbness)  Blockage of pulmonary artery  Can be fatal  patients often die within 2 hours of onset  Treatment Operator Remain Calm (P) Position: Place patient in position of THEIR CHOICE – usually upright C-A-B: Circulation – Airway – Breathing (D) Definitive Care: Remove instruments and sharp objects away from patient Loosen tight clothing in neck region Calm patient Correct respiratory alkalosis: 1. 3-3-3 breathing technique 2. Breathe through pursed lips (like a straw) or nose 3. Try breathing into cupped hands, breathing in CO2, and warming hands (brown paper bag NO longer recommended) Do NOT administer Oxygen to a Hyperventilating Patient Treatment Cont. Monitor vital signs If symptoms do not improve contact EMS (911) Document incident thoroughly  Reference Malamed, S. F. (2022). Medical emergencies in the dental office. Elsevier. Little, J. W., Miller, C., & Rhodus, N. L. (2017). Little and Falace’s dental management of the medically compromised patient. Mosby. Grimes, E. B. (2014). Medical emergencies: Essentials for the Dental Professional. Prentice Hall