Chest
Clinical Investigations: Breathing and not Breathing: ArticlesPatients with Acute Hyperventilation Presenting to an Inner-City Emergency Department
Section snippets
Patients
We studied 23 consecutive patients presenting with an episode of acute hyperventilation over a period of 1 year. The patient register was checked to ensure that no patients had been missed over the study period. Diagnosis of acute hyperventilation was made on clinical grounds by the emergency department physicians on the basis of history, observation, and examination, and in five patients arterial blood gas determinations, taken within the first 2 h of presentation to the hospital. In all
Results
Our patients were almost equally divided between men (12) and women (11). The presenting complaints are listed in Table 1 and were elicited by the emergency department physicians at the time of initial presentation. No patient with an organic cause for their complaints was referred to us, and in all cases, chest radiograph, blood biochemistry, and full blood cell count measured at the time of presentation were normal. No patient presented with any symptoms or signs suggestive of asthma, and
Discussion
Patients with acute hyperventilation are well known to all emergency departments, but to our knowledge, this study is probably the first to attempt to study these difficult patients at and soon after the time of initial presentation. In common with most studies that rely on busy emergency department staff for patient selection, the selection criteria could be criticized in that arterial blood gas data were available only in about one fourth of the patients referred, and this blood was sometimes
Acknowledgments
Dr. J. Costello, Director of the Department of Respiratory Medicine, and Professor R. Murray, head of the Academic Department of Psychological Medicine, provided laboratory facilities.
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The Wellcome Trust provided financial support.
revision accepted May 17.