Altered Breathing

I get so many calls that are top priority because of “Difficulty in breathing” or “Altered breathing”, and when I turn up there is nothing wrong with their breathing (except they are maybe crying, whimpering, or have a runny nose).
So I've just come from a chest pain job which was sent to me as “Normal breathing” – and when I turn up the patient is hyperventilating (breathing way too fast). The one time that someone really does have altered breathing and I'm the last to know…

I spent an hour calming her down and getting her breathing back to normal – I really should work on my hypnosis skills for relaxing people quickly.

17 thoughts on “Altered Breathing”

  1. But is “hyperventilating” actually a “problem” at all? Or what else was wrong with her? I'm not sure but isn't it true that you can get chest pain because of the hyperventilating (and stomach-ache?) Or was she hyperventilating due to the chest pain? Is it actually dangerous? What can you do about it and what can happen? (I always thought it was mainly a “teenager problem”)And why did it take you one hour to calm her down? Where was the ambulance? Do you usually deal that long with patients while going on the RRU? Is your job normally done when the ambulance turns up?

  2. I work as a first-aider at gigs for my University, and one of my skills is calming down the hyperventilating girls; (big grin – they think you'r amazing. then start it all again)Cure of the day? – Give 100% 02 till they pass out! (however probably not best practice!)

  3. I think you're sort of assuming that people are hyperventilating due to anxiety – this is just one of the possible causes. Usually, if someone's hyperventilating, it means that for one reason or another, they are not getting enough oxygen. EMTs have very few diagnostic tools, and blood pressure, pulse rate, and respiration are the ones that indicate the most serious problems – someone hyperventilating is generally very close to becoming an unstable patient that needs intervention right away….This is a bad sign that indicates pending respiratory failure, a cardiac issue, shock or allergic reaction, overdose, lots and lots of bad things. For some of these, oxygen alone will fix it, in others you may have to “bag” (provide manual respiration for) the patient, or address the underlying cause of the hyperventilation – by removing them from a toxic environment, or treating an allergic or asthmatic event.

    So, sometimes,

    Someone gets anxious – > they hyperventilate.

    More often,

    Someone hpyerventilates -> they get anxious -> they hyperventilate more -> things get serious.

    If someone's just hyperventialting because they're freaking out, and they're relatively sane, they generally find it almost irresistible to follow you if you sit in front of them, tell them what you're doing, and calmly, insistently, visibly, breathe slowly. It's like how you have to yawn if you see someone yawn…

  4. I really should put this into a post of it's own…But to cut a long story short –

    You can get lots of symptoms from hyperventilating, including chest pain, pins and needles, dissyness, vomiting, painful throat, painful breathing, cramps and towards the end fitting and unconsciousness.

    It's not massively dangerous, and is normally self limiting.

    The only treatment is to calm the patient down (unfortunately we aren't allowed to slap hysterical people like they do in the old movies – no matter how much we'd like to)

    I spent an hour on scene because I cancelled the ambulance (I'd rather waste my time rather than an ambulance that can actually take sick people to hospital). Some people can take an hour to calm down, others take five minutes and the patient didn't want to go to hospital.

    And yes, when the ambulance turns up I can often hand over responsibility to the crew (but I do hang around if the crew need a hand dealing with the patient).

  5. when I talk about hyperventilating on this blog, unless I mention it as part of something larger (like heart failure) it's to do with anxiety attacks.Anxiety attacks are pretty much self limiting, as people will generally pass out before doing too much damage to themselves. However between anxiety and unconsciousness is some rather painful cramping.

    Over here 'hypervenitilating' is often a pseudonym for 'panic attack', and 'medically caused' hyperventilating is just given as “resps of 44”.

  6. Heh heh…Once upon a time, when I was an evil A&E nurse I would calm the patient down, and then wind them up and watch them go…

    I don't do that now – because I am much happier in my work, but it's an easy thing to do.

  7. Yep.Two podcasts done (one spoken, one music). Both are a bit rough around the edges, and then half an hour before putting them out to you lot – I turn on the telly and one of the tracks downloaded fom Alabama 3's site is being released as a single.

    I have no desire to deal with copyright lawyers.

    So I need to redo the music podcast, and I feel the need to polish up the spoken one. Both of which will have to wait until after I come back from Seattle.

  8. May I suggest solar breathing? Hold the persons hands (if they are clean…) with your thumb in the centre of their palm. Get them to breathe with you, slowly in and out, making eye contact, pressing gently with your thumb as you breathe in, releasing as you breathe out. It is a reflexology technique which I have always found remarkably good. Also cures hiccups.

  9. I'll have to give that a go next time – I'll let you know how it goes.The other thing I might do is lay them flat and “bag” them into a slower rythmn, that apparently works as well.

  10. We have vomit bags (sometimes, somethimes we have bowls) – but the same effect can be achieved by having a non-rebreathing oxygen mask over their mouth, but not connecting it to the oxygen. Again it works by forcing you to breathe your own CO2

  11. Our 100% masks have the one way valve thing so that wont work,bagging a patient tends to look a bit excessive and generally incites panic and feer into bystanders/mentors :p

    reflexology sounds funkey, may try all ove the above next time, by “calm[ing] the patient down, and then wind them up and watch them go… ” I need a new profession, and I suit green better than blue.

  12. A-ha – now look at that mask with a pair of scissors and a roll of tape in your hand…Can you see how it can be made into an effective 'paper bag'?

    (Rumours that I threaten my patients with a plastic bag over the head are entirely false…for a change)

    And I am so much happier in the green than in the blue.

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