An out-of-hospital perspective on hyperventilation syndrome

Abstract

Overview A variety of causes and conditions are associated with hyperventilation, including acute and chronic hyperventilation syndrome (HVS). The characteristics of HVS are not well defined but it results from a reduction in carbon dioxide and altered pH in the body from overbreathing. Symptoms vary between individuals but usually include altered sensations in the extremities, nausea and headache. Diagnosing patients with this condition can be difficult; diagnostic tools include the hyperventilation provocation test, voluntary overbreathing, the Nijmegen questionnaire and the exclusion of physiological causes in the acute situation. There are various prehospital patient presentations and differentiating between potential underlying causes is vital to appropriate treatment and patient safety. Treatments vary in nature, depending on the desired effect and the clinician's scope of practice. Some aim to reduce the frequency and intensity of attacks while others combat the attack when it strikes. This review briefly discusses some treatments available to a clinician with a basic skill level. Research with a focus on the out-of-hospital environment is recommended.