NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesMedium
A 19-year-old female is found hyperventilating, complaining of numbness and tingling in her hands and feet, and feeling lightheaded. She states she just had a fight with her boyfriend. Her vital signs are stable, and her SpO2 is 99%. What is the MOST appropriate initial intervention?
- AEncourage her to slow her breathing and reassure her.
- BPrepare for immediate transport to the nearest hospital.
- CHave her breathe into a paper bag.
- DAdminister high-flow oxygen via non-rebreather mask.
Show answer & explanationAnswer & explanation
Correct answer: A. Encourage her to slow her breathing and reassure her.
The patient's symptoms (hyperventilation, numbness/tingling, lightheadedness) after an emotional event, with stable vitals and normal SpO2, are classic for hyperventilation syndrome. The most appropriate initial intervention is to calm the patient and encourage slower, controlled breathing to correct the respiratory alkalosis.
Why the other options are wrong
- B. While transport may eventually be necessary if symptoms don't resolve or other causes are suspected, initial management focuses on calming the patient and correcting the breathing pattern at the scene.
- C. Breathing into a paper bag is an outdated and potentially dangerous intervention as it can lead to hypoxia in patients with underlying respiratory conditions. It is no longer recommended.
- D. Administering high-flow oxygen is generally not indicated for hyperventilation syndrome as the patient is typically already hyperoxygenated (SpO2 99%). It can worsen anxiety.
Hyperventilation Syndrome Management
Management of hyperventilation syndrome, often triggered by anxiety, focuses on calming the patient and coaching them to slow their breathing rate to normalize carbon dioxide levels, which alleviates symptoms like numbness and tingling.
- Caused by excessive breathing, leading to decreased CO2 (respiratory alkalosis).
- Symptoms: numbness/tingling (paresthesias), lightheadedness, anxiety, chest pain.
- Treatment: reassurance, coaching slow breathing; avoid paper bag.
Memory trick: Calm Down, Breathe Slow, No Bag!