Hyperventilation

Question 1

What is hyperventilation?

Answer 1

Hyperventilation is an extreme form of tachypnoea resulting in significant hypocapnia and subsequent respiratory alkalosis.

Question 2

What are potentially life-threatening conditions that could cause a rapid respiratory rate?

Answer 2

1. Lung pathology:
   - PE
   - Pneumothorax
   - Asthma
   - Pneumonia
2. Brain pathology:
   - Hypoxia
   - Brain stem injury
3. Systemic illness:
   - Heat stroke
   - Anaphylaxis
   - Toxidromes (e.g. TCA or aspirin)
   - Metabolic acidosis (e.g. diabetic ketoacidosis)

Question 3

What are the clinical features of hyperventilation?

Answer 3

• Rapid, tachypnoea
• Paraesthesia (pins & needles) around the mouth, hands and feet
• Restlessness
• Dyspnoea
• Pain
• Vertigo
• Carpopedal spasms
• Eventually unconsciousness

Question 3

What are the clinical features of hyperventilation?

Answer 3

• Rapid, tachypnoea
• Paraesthesia (pins & needles) around the mouth, hands and feet
• Restlessness
• Dyspnoea
• Pain
• Vertigo
• Carpopedal spasms
• Eventually unconsciousness

Question 4

Outline the treatment protocol for hyperventilation.

Answer 4

Is there any evidence of lung or brain pathology or systemic illness?

If yes, manage as per relevant CPG.

If no, is a psychological cause likely?

• If yes, calm the patient and encourage a decreased respiratory rate.
• If no, consider other causes & transport