Panic Attack’s – What You Need to Know

A panic attack or hyperventilation is a state of breathing faster or deeper than normal.

Healthy breathing is when there is a balance between breathing in and breathing out. Hyperventilation is caused by exhaling more than you inhale. This causes a rapid reduction in carbon dioxide in the body.

These attacks are rare, with most people reporting occurrences of 1 to 2 times in their lifetime. There can be many causes of hyperventilation and common triggers include emotions of stress, anxiety, depression, or anger.

Occasionally, hyperventilation from a panic can be related to a specific phobia, such as a fear of heights, dying, or closed-in spaces (claustrophobia), and often, panic and hyperventilation become a vicious cycle.

The cause of hyperventilation cannot always be determined with sufficient accuracy (especially in the early stages) within the pre-hospital environment. Therefore you should always presume hyperventilation is secondary to hypoxia or another underlying respiratory disorder until proven otherwise.

Hyperventilation may occur secondary to a life-threatening condition such as asthma or anaphylaxis.

Recognition of hyperventilation

  • Previous history of panic attacks or hyperventilation
  • The immediate history of an emotional event
  • Fast, shallow rate of breathing
  • Chest tightness or pain
  • Pins and needles/tingling in the hands, face, and around the lip
  • Hands in spasm (claws)

First aid for hyperventilation

  • Remove the patient from any distressing triggers
  • Attempt to control their breathing by ‘coaching’ – get them to copy your breathing pattern
  • Assess for any underlying causes: is this asthma or anaphylactic attack
  • Obtain medical help if symptoms do not resolve

When to seek treatment for hyperventilation

Hyperventilation can be a serious issue. Symptoms can last 20 to 30 minutes. You should seek treatment for hyperventilation when the following symptoms occur:

  • Rapid, deep breathing for the first time
  • Hyperventilation that gets worse, even after trying home care options
  • Pain
  • Fever
  • Bleeding
  • Feeling anxious, nervous, or tense
  • Frequent sighing or yawning
  • Pounding and racing heartbeat
  • Problems with balance, lightheadedness, or vertigo
  • Numbness or tingling in the hands, feet, or around the mouth
  • Chest tightness, fullness, pressure, tenderness, or pain

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