Hyperventilation

[BunnyBunnyBSNRN, ASN, BSN]

Now that I'm at the jr high, I've had to deal with a couple of student who push themselves too hard during athletics then end up in my office hyperventilating. I have delt with this by teaching them pursed lipped breathing and encouraging them to slow down, even counting slowly while they breath in and out. What else can I do? Does anybody have any tricks?

BTW, it doesn't help that one of them is a bit of a drama queen and thinks she's dying everytime she gets a paper cut!

[safarirn]

For my non-asthmatics, I just talk very calmly and slowly & tell them to "slllloooowww down. take a deep breath in.... now let it out. Slooooowwwww doowwn. Concentrate on your breathing... etc."

Usually that's all it takes to get them through the episode.

After they are calm I have them drink water, take their vitals, & send them on their way if they're ok.

As for prevention... educate & reinforce is all I've got for ya.

[schooldistrictnurse]

I keep brown paper lunch bags in the nurse's room at middle and high school for hyperventilating students to use to re-breathe and increase their CO2 level. This remedy is old-school but I don't think it's been scientifically discounted. Plus, the student thinks it will improve their condition, and that alone can be a big help!

[safarirn]

found this on a medical site...

"Paper bags have been used for years to treat hyperventilation syndrome. The idea is that rebreathing the air we exhale makes us inhale more CO2 and helps us to quickly add the CO2 back into our bloodstreams. It works. Breathing into a paper bag has been shown to increase CO2 levels in the blood, although not as quickly or as effectively as many doctors previously thought. In one study, patients who thought they were getting something similar to the paper bag treatment did nearly as well as the real paper bag group.

The problem with paper bags is not that true hyperventilation syndrome patients are at risk from the treatment. On the contrary, while it hasn't been shown to really help hyperventilation syndrome patients, it hasn't been shown to hurt them, either. What paper bags do hurt are the dangerous medical conditions that look like hyperventilation. Heart attacks and asthma are most commonly confused with hyperventilation syndrome.

Breathing into a paper bag restricts the fresh air you are able to get. Without fresh air, too little oxygen is in the air you're inhaling. So, breathing into a paper bag dangerously lowers the amount of oxygen in your bloodstream. There have been several documented cases of heart attack patients incorrectly thinking they had hyperventilation syndrome and fatally worsening their heart attacks by breathing into a paper bag.

To make matters worse, several studies now show a link between high concentrations of CO2 and panic attacks, which means that artificially increasing CO2 in inhaled air is likely to trigger more feelings of panic in patients who suffer from anxiety.

The best treatment of hyperventilation syndrome is to stay calm and practice breathing slowly and not too deeply. Calmness and breathing exercises have just as much success as paper bag breathing, and no one is going to die from staying calm."

[schooldistrictnurse]

Good to know.

thanks

[Flare, ASN, BSN]

i've brought one of my kindergarten tools to the middle school - a pinwheel.

when the kids come in hyperventilating, i give then the pinwheel and tell them to blow at it slowly. The pinwheel goves them somethnig else to focus on and lets me gauge how fast and strong they are blowing.

[safarirn]

firefightingRN, you're a genius!

[Flare, ASN, BSN]

lol thanks gang - just glad to share a useful tidbit. By the way, soap bubbles work too, but are messy. When my father in law was recovering from his CABG i asked him to blow bubbles with the kids, specifying to impress them by blowing big bubbles.

[rn/writer, RN]

Love the pinwheel idea!

When I was an EMT, we used to try to get suspected hyperventilation patients talking about something of interest to them. If the condition is really asthma or something else, they won't be able to carry on much of a conversation. But if it is hyperventilation, talking about something they care about will, 1) take the immediate focus off of their breathing and their panicky feelings, and, 2) get them to redirect the huffing and puffing into speaking.

Doing this can take a couple of minutes (although I've seen it start to work in about 45 seconds), and it has the benefit of establishing a connection and building trust. The trick is to pick a non-medical topic that will draw the kid in, even as you are assessing and helping them to calm down.

Because it's kind of a sideways approach, resistance doesn't occur to them.

This can work even when the hyperventilation has reached the level of carpal spasm.