NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesMedium
A 19-year-old female is found hyperventilating, complaining of numbness and tingling in her fingers and toes. She is visibly distressed and states she just had a fight with her boyfriend. Her skin is pale and cool. What is the MOST appropriate initial intervention?
- AReassure her and encourage slow, deep breathing.
- BAdminister oxygen via non-rebreather mask.
- CPrepare for rapid transport due to potential cardiac event.
- DHave her breathe into a paper bag.
Show answer & explanationAnswer & explanation
Correct answer: A. Reassure her and encourage slow, deep breathing.
The patient's symptoms (hyperventilation, numbness/tingling in extremities, emotional distress) are classic for hyperventilation syndrome. The most appropriate initial intervention is to reassure the patient and coach her to slow her breathing, which helps to normalize carbon dioxide levels and resolve the symptoms.
Why the other options are wrong
- B. Administering oxygen is generally not indicated and can sometimes worsen anxiety in hyperventilation syndrome.
- C. While always considering other causes, the classic symptoms point to hyperventilation syndrome, which is typically not a cardiac emergency.
- D. Breathing into a paper bag is no longer recommended due to risk of hypoxia in other conditions.
Hyperventilation Syndrome Management
Hyperventilation syndrome is characterized by rapid, deep breathing often triggered by anxiety, leading to excessive carbon dioxide exhalation, and symptoms like lightheadedness, tingling, and chest pain.
- Caused by a decrease in arterial carbon dioxide (respiratory alkalosis).
- Symptoms include paresthesias (tingling), lightheadedness, carpopedal spasms, and chest pain.
- Treatment focuses on calming the patient and coaching slow, controlled breathing.
- Rule out other serious causes before diagnosing hyperventilation syndrome.
Memory trick: Calm the breath, calm the mind, no bag to bind!