Is hyperventilation implemented anymore?

[Caspar]

Specifically for NYS, is it still protocol to hyperventilate a patient in a major trauma (assuming they fit the criteria). The new protocols don't list it anymore, but they never explicitly said that they took it out.

 

[Flying]

Specifically for NYS, is it still protocol to hyperventilate a patient in a major trauma (assuming they fit the criteria). The new protocols don't list it anymore, but they never explicitly said that they took it out.

Hyperventilation (once every 2-3s) is not done routinely anymore. I don't see this being productive at the BLS level because few EMTs are good enough at BVM/airway management to make a hyperventilation protocol anything more than uncontrolled bagging.


Aside from that, the NYDoH gives a similar rationale:
http://www.health.ny.gov/professionals/ems/policy/s97-03.htm
Making prehospital providers "stick with what they know" is probably best for the patient.

 

[WolfmanHarris]

Relative hyperventilation of a closed head injury with signs of cerebral herniation is still indicated, but likely not in the way you're thinking. It's not that you'll be ventilating them at 30+ bpm. In the closed head injury Pt. ventilate at a rate of 6-8 ppm w/ a goal ETCO2 of 35-40 (low end of normal).

When the Pt. begins to present with signs of cerebral herniation, that is the typical cushings triad of bradycardia, hypertension and narrowing pulse pressure, then you will need to increase the rate of ventilation to compensate. At that point hyperventilation may be indicated but even then your vent rate should not exceed 20/min while still striving for an ETCO2 of 35-40.

 

[NysEms2117]

for nys my teacher said a NRB with no oxygen, but she said do it if you know what your doing, only paramedics get paper bags . As previously mentioned.

 

[STXmedic]

for nys my teacher said a NRB with no oxygen, but she said do it if you know what your doing, only paramedics get paper bags . As previously mentioned.

I think you may be confused. And I think your teacher may be a bit special.

 

[NysEms2117]

was just a joke >.<.. No offense meant by it, sorry if you took it that way :/

 

[STXmedic]

was just a joke >.<.. No offense meant by it, sorry if you took it that way :/

I didn't take any offense, I just don't know how anxiety/hyperventilation like you're referring to has anything to do with the hyperventilation of a TBI patient.

 

[ERDoc]

Sometimes humor and sarcasm can be lost on the internet. Smileys are helpful.

 

[MrLegsGuy]

I didn't take any offense, I just don't know how anxiety/hyperventilation like you're referring to has anything to do with the hyperventilation of a TBI patient.

Bahahaha Thanks for the visual at least!
"Sir, I want you to breath into this bag"
*Piece of skull falls off*

Oh lordy, I'm awful

When I went through academy a little over a year and a half ago, it was indicated ONLY if the PT shows signs of severe head injury, is unable to communicate, typically a GCS of <5

 

[bakertaylor28]

Outside of Preparation for an invasive airway (such as an ET, King, or Combi) I've yet to see any consistent hyperventilation protocol. ET and King are ACLS, but from what I hear, BLS still might use a combi occasionally.

 

[VentMonkey]

Outside of Preparation for an invasive airway (such as an ET, King, or Combi) I've yet to see any consistent hyperventilation protocol.

Um, no. Four full volume breaths via BVM is hardly hyperventilating prior to invasive airway management. Most of the more progressive systems are implementing passive oxygenation techniques though.

 

[bakertaylor28]

Um, no. Four full volume breaths via BVM is hardly hyperventilating prior to invasive airway management. Most of the more progressive systems are implementing passive oxygenation techniques though.

That's what i thought- Though thats what our protocol calls it- hyperventilation. Of course when your BVM has O2 (or better yet heliox) cut wide open on it I suppose it could sometimes look that way. Frankly I had no idea WHAT they were thinking when they wrote things out that way...