med emergency- respiratory disress

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Chapter 9
Hyperventilation

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Objectives
• Upon completion of this chapter, you will
be able to:
– Define hyperventilation
– Describe the signs and symptoms of
hyperventilation
– Explain the causes of hyperventilation
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Objectives (cont’d.)
– Explain the treatment of hyperventilation
– Describe the best way to prevent
hyperventilation
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Introduction
• Hyperventilation: an increase in the rate or
depth of breathing that results in a change
in the blood chemistry
– Usually occurs as a result of anxiety
– A common emergency in the dental office
since dental visits can cause anxiety for some
people
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Causes
• Most common cause is anxiety
• Can also be caused by:
– Certain physical conditions
– Emotional upset
– Stress
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Causes (cont’d.)
• Hyperventilation occurs most often in
patients who hide their feelings and do not
admit their fears of dentistry
– Anxiety builds until they are no longer able to
control it
• Not usually seen in children
– Children tend to cry or scream when fearful
preventing hyperventilation
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Physiology
• Carbon dioxide in the blood automatically
triggers the breathing reflex and stimulates
respiration
• A person hyperventilating increases the
depth and rate of respirations and exhale
a large amount of carbon dioxide
– Suffer from a lack of carbon dioxide
– Must work consciously to inhale and exhale
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Physiology (cont’d.)
• Cycle of hyperventilation
– Patient:
• Becomes anxious
• Begins to hyperventilate
• Realizes he/she is having trouble breathing
• Becomes more anxious
• Hyperventilates more severely
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Physiology (cont’d.)
– Cycle continues until dental team recognizes
the problem, intervenes, and attempts to calm
the patient
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Signs and Symptoms
• Patient:
– Appears anxious
– Begins to breathe faster and deeper
– Usually does not realize the change in
breathing
– May complain of chest tightness or suffocation
– May experience dizziness and tingling in the
extremities
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Signs and Symptoms (cont’d.)
Emergency Basics Box 9-1: Signs and Symptoms of Hyperventilation
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Treatment
• Stop all dental treatment
– Remove all materials and instruments from
the patient’s mouth
• Position the patient upright
– Patient will be more comfortable if seated
upright
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Treatment (cont’d.)
• Attempt to calm the patient
– Explain the condition to the patient
– Tell the patient to inhale and hold their breath
for several seconds prior to exhaling
• If the patient is too upset to hold their
breath, use other techniques
– Have the patient breathe into a paper bag
– Allow the patient to hold the paper bag
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Treatment (cont’d.)
• Do not administer oxygen
– Patient has too much oxygen and not enough
carbon dioxide
• The dentist may have to administer an
anti-anxiety medication
– If the patient is experiencing a severe
hyperventilation episode
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Summary
• Hyperventilation usually occurs in the
dental office because of anxiety
• Important for the dental team to determine
what the patient fears about dentistry
– Can help prevent future episodes of
hyperventilation
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