What are the key aspects of hyperventilation syndrome for EMS providers. How can EMS professionals differentiate between panic-induced hyperventilation and life-threatening conditions. What are the most effective treatment approaches for hyperventilation syndrome in prehospital settings.

The Nature and Causes of Hyperventilation Syndrome

Hyperventilation syndrome is a complex respiratory condition that EMS providers frequently encounter. It occurs when a patient’s respiratory rate surpasses the body’s metabolic requirements for oxygen and carbon dioxide exchange. While often associated with panic attacks, hyperventilation can also be a symptom of various serious medical conditions.

Panic-Induced Hyperventilation

In cases of panic-induced hyperventilation, patients experience a sudden onset of intense fear, accompanied by physical symptoms such as:

• Chest pain or palpitations
• Shortness of breath
• Diaphoresis (excessive sweating)
• Nausea
• Dizziness or light-headedness

As the panic attack progresses, patients may find themselves unable to control their rapid breathing, leading to a cycle of worsening anxiety and respiratory distress. This type of hyperventilation, while distressing for the patient, is generally self-limiting and physiologically benign.

Physiological Mechanisms of Hyperventilation

During hyperventilation, excessive carbon dioxide is expelled from the body, resulting in hypocapnea (decreased partial pressure of CO2 in the bloodstream). This leads to respiratory alkalosis, which has several effects on the body:

• Increased oxygen binding to hemoglobin, reducing tissue perfusion
• Cerebral vasoconstriction, potentially causing syncope and altered mental status
• Decreased calcium levels, leading to numbness, tingling, and carpopedal spasms

In panic-induced cases, these symptoms typically resolve once the patient’s respiratory rate normalizes.

Differentiating Panic-Induced Hyperventilation from Life-Threatening Conditions

EMS providers must be vigilant in distinguishing between panic-induced hyperventilation and other serious medical conditions that can present with similar symptoms. Hyperventilation can be a compensatory response to various life-threatening situations, including:

• Asthma
• Pulmonary embolism
• Spontaneous pneumothorax
• Acute coronary syndrome
• Cardiac dysrhythmias
• Sepsis
• Diabetic ketoacidosis
• Drug overdose
• Stroke

In these cases, the hyperventilation is the body’s attempt to compensate for an underlying problem, and reducing the respiratory rate could exacerbate the condition.

Key Assessment Considerations

When evaluating a hyperventilating patient, EMS providers should:

1. Always begin by ruling out life-threatening causes of hyperventilation
2. Consider panic-induced hyperventilation as a diagnosis of exclusion
3. Look for precipitating events or triggers, such as arguments, bad news, or phobias
4. Inquire about the patient’s history of panic attacks and compare current symptoms to previous episodes

EMS Management Strategies for Hyperventilation Syndrome

Effective management of hyperventilation syndrome in the prehospital setting requires a balanced approach that addresses both the physical and psychological aspects of the condition.

Initial Assessment and Stabilization

Upon encountering a hyperventilating patient, EMS providers should:

1. Ensure scene safety and establish rapport with the patient
2. Perform a rapid assessment of airway, breathing, and circulation
3. Obtain vital signs, including respiratory rate, heart rate, blood pressure, and oxygen saturation
4. Conduct a focused physical examination, paying particular attention to respiratory effort and lung sounds

Calming Techniques and Reassurance

For patients experiencing panic-induced hyperventilation, employing calming techniques can be highly effective:

• Speak in a calm, reassuring manner
• Explain the nature of hyperventilation and its self-limiting characteristics
• Guide the patient through slow, controlled breathing exercises
• Encourage the use of diaphragmatic breathing

Breathing Regulation Methods

Several methods can help patients regulate their breathing:

1. Pursed-lip breathing: Inhale slowly through the nose, then exhale through pursed lips
2. Square breathing: Inhale for a count of four, hold for four, exhale for four, hold for four, and repeat
3. Diaphragmatic breathing: Focus on breathing deeply from the abdomen rather than the chest

It’s important to note that traditional interventions like breathing into a paper bag are no longer recommended due to potential risks and limited efficacy.

Pharmacological Interventions in Hyperventilation Syndrome

While medication is not typically the first-line treatment for panic-induced hyperventilation, in some cases, pharmacological interventions may be necessary.

Anxiolytic Medications

In severe cases of panic-induced hyperventilation that do not respond to non-pharmacological interventions, anxiolytic medications may be considered under medical direction. These may include:

• Benzodiazepines (e.g., lorazepam, diazepam)
• Selective serotonin reuptake inhibitors (SSRIs) for long-term management

However, the use of these medications in the prehospital setting is generally limited and should be approached with caution.

Addressing Underlying Conditions

If hyperventilation is secondary to another medical condition, treatment should focus on addressing the underlying cause. This may involve:

• Bronchodilators for asthma
• Anticoagulants for suspected pulmonary embolism
• Oxygen therapy for hypoxia
• Fluid resuscitation for sepsis

Documentation and Handoff Considerations for Hyperventilation Cases

Proper documentation and handoff are crucial in ensuring continuity of care for patients with hyperventilation syndrome.

Key Elements of Documentation

EMS providers should document the following information:

• Initial presentation and vital signs
• Precipitating factors or triggers, if identified
• Interventions performed and patient response
• Changes in patient condition during transport
• Any medications administered

Effective Handoff Communication

When transferring care to the receiving facility, EMS providers should:

1. Provide a concise summary of the incident and interventions
2. Highlight any concerns about underlying conditions
3. Communicate the patient’s response to treatment
4. Share any relevant history of panic attacks or anxiety disorders

Long-Term Management and Patient Education for Hyperventilation Syndrome

While EMS providers primarily focus on acute management, they can play a role in educating patients about long-term strategies for managing hyperventilation syndrome.

Patient Education Topics

EMS providers can offer brief education on:

• Recognizing early signs of panic attacks
• Techniques for controlled breathing
• The importance of follow-up with primary care or mental health professionals
• Lifestyle factors that may help reduce anxiety and panic attacks

Referral to Mental Health Services

For patients with recurrent episodes of panic-induced hyperventilation, EMS providers can emphasize the importance of seeking professional mental health support. This may include:

• Cognitive-behavioral therapy
• Stress management techniques
• Medication management by a psychiatrist

Challenges and Controversies in Managing Hyperventilation Syndrome

The management of hyperventilation syndrome in the prehospital setting is not without its challenges and controversies.

Misdiagnosis Risks

One of the primary concerns in managing hyperventilation syndrome is the risk of misdiagnosis. EMS providers must balance the need to quickly identify and treat life-threatening conditions with the goal of avoiding unnecessary interventions for benign panic-induced hyperventilation.

How can EMS providers minimize the risk of misdiagnosis in hyperventilation cases? By maintaining a high index of suspicion for serious underlying conditions, conducting thorough assessments, and closely monitoring the patient’s response to initial interventions. If symptoms persist or worsen despite appropriate calming techniques, providers should consider alternative diagnoses and be prepared to escalate care as needed.

Evolving Treatment Approaches

The approach to managing hyperventilation syndrome has evolved over time, with some traditional methods falling out of favor. For example, the once-common practice of having patients breathe into a paper bag is no longer recommended due to potential risks such as hypoxia and delayed diagnosis of serious conditions.

What are the current best practices for managing hyperventilation in the field? Current recommendations focus on non-invasive techniques such as calm reassurance, guided breathing exercises, and distracting the patient from their symptoms. These methods are generally considered safer and more effective than older approaches.

Balancing Empathy and Clinical Judgment

EMS providers face the challenge of balancing empathy for a distressed patient with the need to maintain clinical objectivity. While it’s important to provide emotional support, providers must also remain vigilant for signs of underlying medical conditions that may require immediate intervention.

How can EMS professionals strike this balance effectively? By developing strong communication skills, providers can offer reassurance while simultaneously conducting a thorough assessment. Active listening, clear explanation of assessment findings, and involving the patient in their care plan can help build trust and cooperation.

Future Directions in Hyperventilation Syndrome Management

As our understanding of hyperventilation syndrome continues to evolve, new approaches to management and treatment are emerging.

Advancements in Diagnostic Tools

Emerging technologies may soon provide EMS providers with more accurate tools for differentiating between panic-induced hyperventilation and other serious conditions. These could include:

• Portable capnography devices for real-time CO2 monitoring
• Advanced point-of-care blood testing for rapid assessment of electrolyte imbalances
• Wearable devices that track physiological markers of anxiety and panic

How might these advancements impact prehospital care for hyperventilation syndrome? By providing more objective data, these tools could help EMS providers make more informed decisions about patient care and transport priorities. This could lead to more targeted interventions and potentially reduce unnecessary emergency department visits.

Integration of Mental Health Resources

There is growing recognition of the need to better integrate mental health resources into prehospital care. Future approaches may include:

• Telemedicine consultations with mental health professionals during EMS calls
• Enhanced training for EMS providers in recognizing and managing anxiety disorders
• Development of community paramedicine programs focused on mental health support

What benefits could these integrations bring to patients with hyperventilation syndrome? By providing more comprehensive mental health support in the prehospital setting, these approaches could help reduce the frequency of panic-induced hyperventilation episodes and improve long-term outcomes for patients with anxiety disorders.

Research into Physiological Markers

Ongoing research is exploring the potential for identifying specific physiological markers that could help distinguish panic-induced hyperventilation from other causes. Areas of investigation include:

• Patterns of heart rate variability associated with panic attacks
• Biomarkers in saliva or sweat that correlate with anxiety levels
• Subtle changes in respiratory patterns unique to panic-induced hyperventilation

How could these research findings impact EMS practice? If reliable markers are identified, they could be incorporated into assessment protocols, potentially leading to more accurate and rapid diagnosis of panic-induced hyperventilation in the field. This could help streamline treatment decisions and improve patient outcomes.

As the field of emergency medical services continues to advance, the management of hyperventilation syndrome will likely become more nuanced and effective. By staying informed about new developments and continuously refining their skills, EMS providers can ensure they are providing the best possible care for patients experiencing this challenging condition.

4 things EMS providers need to know about hyperventilation syndrome

Hyperventilation syndrome is a challenging and often misunderstood condition that is frequently encountered in EMS. When triggered by anxiety, hyperventilation causes patients to feel like they are suffocating, but it eventually self-corrects and is physiologically benign.

Hyperventilation is also a sign of several life-threatening metabolic, respiratory and circulatory conditions, which can present with similar assessment findings and vital signs as panic-induced hyperventilation. Here are four things to know to identify and treat panic-induced hyperventilation syndrome.

When triggered by anxiety, hyperventilation causes patients to feel like they are suffocating, but it eventually self-corrects and is physiologically benign. (Photo/Needpix)

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1. Hyperventilation syndrome is primarily a respiratory problem triggered by panic

Hyperventilation syndrome is a condition in which a patient’s respiratory rate exceeds the body’s metabolic demands for oxygen and carbon dioxide. It is closely related to panic attacks, where the patient experiences a sudden onset of intense fear, with or without an identified trigger, along with physical symptoms including:

• Chest pain or palpitations
• Shortness of breath
• Diaphoresis
• Nausea
• Dizziness or light-headedness

Panic attacks progress to hyperventilation syndrome when patients continue to breathe faster than they are able to control, and use chest muscles rather than their diaphragm for ventilation. This leaves little room for the chest to expand and the patient feels like they are suffocating. The patient then feels like they need to breathe even faster and deeper, leading to a cycle of worsening anxiety and respiratory distress.

Panic-induced hyperventilation causes more carbon dioxide to be exhaled than the body can produce, which decreases the partial pressure of CO2 in the bloodstream (PaCO2), or hypocapnea. Hypocapnea leads to respiratory alkalosis, which causes oxygen to bind more strongly to hemoglobin and less is released for tissue perfusion. Acute respiratory alkalosis also causes cerebral vasoconstriction and decreased blood supply to the brain, which can lead to syncope and altered mental status. Calcium levels also decrease in respiratory alkalosis, which can cause numbness, tingling and spasms of the patient’s hands and feet, known as carpopedal spasm. When triggered by a panic attack, the patient’s symptoms improve and the electrolyte levels normalize once they slow their respiratory rate.

2. Hyperventilation is also a response to respiratory, perfusion or metabolic compromise

Panic attacks are only one cause of hyperventilation. Elevated respiratory rate, difficulty breathing, anxiety, chest discomfort, diaphoresis, syncope, and extremity spasms can be caused by other life-threatening conditions, including:

• Asthma
• Pulmonary embolism
• Spontaneous pneumothorax
• Acute coronary syndrome
• Cardiac dysrhythmias
• Sepsis
• Diabetic ketoacidosis
• Overdose
• Stroke

Hyperventilation associated with these conditions is caused by the body compensating for an underlying problem, which will be made worse if the patient reduces their respiratory rate.

3. Understand how to interpret assessment findings in hyperventilating patients

Always start your assessment by look for life-threatening causes of hyperventilation, and panic-induced hyperventilation should always be a diagnosis of exclusion.

Panic attacks usually have a precipitating event, such as an argument, bad news or a phobia, but they do not always have an identifiable trigger. Patients also often have a history of panic attacks and can compare their present symptoms to previous ones. Remember that other conditions may have been misdiagnosed as panic attacks in the past, and also that pulmonary embolism, sepsis, diabetic ketoacidosis can cause hyperventilation in young and otherwise healthy people. Vasospasm associated with respiratory alkalosis can also trigger acute coronary syndromes.

Pulse-oximetry and waveform capnography are valuable tools to assess patients with hyperventilation syndrome, but they also have limitations.

Patients with panic-induced hyperventilation should be well oxygenated and have a pulse-oximetry reading above 95%. Obtaining a reliable pulse-oximetry reading may be challenging if a patient’s fingers are constricted or they do not remain still. Administer supplemental oxygen if the patient’s pulse-oximetry reading is low (below 94%), or if a reliable pulse-oximeter reading is not available. Supplemental oxygen will not worsen the hyperventilation, and it is vital for patients who are hypoxic.

Waveform capnography is especially useful in assessing patients who are hyperventilating. Capnography provides real-time feedback on respiratory rate, and the amount of carbon dioxide exhaled with each breath (ETCO2), and air movement through the lower airways.

While the normal range of ETCO2 is between 35 and 45 mmHg, and a normal capnogram is rectangular-shaped. Hyperventilating patients who eliminate excess of CO2 would have an ETCO2 reading below 30 mmHg. In a patient whose panic attack is worsening, ETCO2 would decrease as their respiratory rate increases. Likewise, a decrease in respiratory rate and rise in ETCO2 suggests that the patient’s panic attack is improving.

Waveform capnography also helps rule out bronchospasm in hyperventilating patients. In addition to auscultating lung sounds, the shape of the capnography waveform during panic-induced hyperventilation would have a crisp rectangular shape, but with bronchospasm it will have a slurred upstroke, or shark-fin appearance. The absence of a slurred upstroke rules out the need for an albuterol treatment, which if given may increase the patient’s heart rate and anxiety.  

In patients who pass out while hyperventilating, monitoring their respiratory rate and ETCO2 can help, but not completely rule out, a more serious cause of syncope. Look for a pattern of increasing respiratory rate and decreasing ETCO2 before the syncopal episode, a short period of apnea during the episode, followed by a higher ETCO2 after the patient regains consciousness. This cycle may repeat if the panic attack continues.  

Unfortunately low ETCO2 with hyperventilation also occurs with shock and metabolic acidosis, particularly severe sepsis and diabetic ketoacidosis. The capnography waveform may have a rounded tombstone shape in these conditions, but may also appear identical to one in a patient with panic-induced hyperventilation. Thus, any hyperventilating patient should be transported to the hospital for evaluation.

4. Coach patients with suspected panic-induced hyperventilation to slow their breathing

Patients truly suffer during panic-induced hyperventilation; more so than many other conditions that EMS is called for. When panic-induced hyperventilation is the most likely cause of hyperventilation after a thorough assessment and consideration of life-threatening causes, EMS providers can play an important role in helping the patient’s symptoms improve before and during transport to the hospital.

Approach patients with empathy and avoid statements such as “relax,” “calm down” or “slow your breathing” – the patient would already have done that if they were able to. Never have the patient breathe into a paper bag or disconnected oxygen mask; this can be fatal if done with a hypoxic patient and is usually ineffective for panic-induced hyperventilation.

Move the patient away from anyone or anything that appears to make them more upset. Position yourself at their level, use gentle eye contact, acknowledge that what they are feeling is real and reassure them that they are safe. Explain that breathing slower and more deeply will help them feel better, and coach them to focus on using their diaphragm to take deeper breaths.

One technique is to show the patient their pulse oximetry and capnography waveform. This helps reassure the patient that they are getting enough oxygen and prompts them to focus on the goal of slowing their breathing.

Panic-induced hyperventilation is a terrifying experience for patients, and they deserve empathy and compassion. Also remember that anxiety is only one cause of hyperventilation, and that other causes are much more serious. Use all available monitoring tools, including pulse oximetry and capnography to assess and treat hyperventilating patients, and always recommend that they be transported to the hospital.

Hyperventilating can help clear alcohol from body faster, researchers find | Medical research

Researchers in Canada have discovered that hyperventilation can significantly increase the rate at which the body eliminates alcohol, in a breakthrough that could save thousands of lives.

Three million people around the world die from alcohol-related deaths each year and emergency room physicians have few effective tools to treat acute alcohol poisoning.

In a proof-of-concept paper published this week in the journal Scientific Reports, a group of Toronto researchers describe how hyperventilating into a device which regulates carbon dioxide levels can eliminate alcohol far faster than conventional treatments.

The device is the size of a briefcase and delivers carbon dioxide to users from a tank, ensuring that CO2 levels in the blood remain constant – thus preventing dizziness and nausea during hyperventilation.

Lead researcher Joseph Fisher, an anesthetist and senior scientist at Toronto General Hospital Research Institute said hospitals are often helpless in cases of alcohol poisoning. Currently, the only intervention to rid the body of excess ethanol is through dialysis – a largely inefficient process.

“[Patients] are coming in unconscious and highly alcohol-intoxicated so they’re hard to examine … And there’s nothing you can do. You have to wait until their livers metabolize it,” Fisher told the Canadian Press.

Operating on the hypothesis the lungs could play a critical role in clearing ethanol, the team had a group of five adults drink half a glass of vodka on two occasions.

After the first drink, it took the participants between two and three hours to clear half of the ethanol from their body, according to Breathalyzer results. The second time, they were instructed to hyperventilate. With each exhalation, Fisher says, alcohol that has evaporated from the blood is released.

The body was able to eliminate the ethanol at a rate three times faster than waiting for the liver to process it. Fisher cautions that the sample is small and requires further testing.

But the peer-reviewed developments are nonetheless promising.

“I used to be an emergency doc and I know they have big issues with patients who – on top of everything else – are also alcohol-intoxicated,” said Fisher, adding that it could also save the lives of young children who accidentally ingest alcohol. “Usually those kids are down for the count but this may be an approach.”

The treatment is unlikely to be repackaged as a cure for hangovers: researchers found that the process was most effective for high levels of intoxication.

This article was amended on 17 November 2020 to clarify that hyperventilating helps eliminate alcohol from the body, but does not metabolize it as an earlier version said. A substance is metabolized when it is affected by chemical processes in the body.

Hyperventilation device can clear alcohol from your system faster

A fascinating new proof-of-concept study is proposing a novel, cheap and surprisingly simple way to rapidly reduce blood alcohol levels. The research suggests a low-tech device aiding safe hyperventilation can more than triple the rate of alcohol eliminated from the body.

Our liver is fundamentally responsible for clearing alcohol out of the body. However, the rate of clearance by the liver is relatively constant, regardless of blood alcohol levels. This can sometimes leave individuals in precariously toxic positions when they have consumed too much alcohol too quickly.

Canadian researcher Joseph Fisher looked to the lungs as a possible solution to speeding up the body’s ability to clear alcohol. For nearly a century it has been known that ethanol, and other volatile compounds, are present in exhaled breath. So Fisher hypothesized hyperventilation could be a way to accelerate the body’s rate of clearing toxins such as alcohol.

“But you can’t just hyperventilate, because in a minute or two you would become light-headed and pass out,” says Fisher, an anesthesiologist at the Toronto General Hospital Research Institute.

The reason we get dizzy or light-headed when we hyperventilate is because the rapid pace of breathing eliminates carbon dioxide from our blood faster than the body can replace it. This causes a condition called hypocapnia.

To allow a person to safely hyperventilate without developing hypocapnia Fisher and a team of colleagues invented a device called ClearMate. The simple invention delivers subjects a mix of carbon dioxide and oxygen, allowing hyperventilation without negative side effects.

“It’s a very basic, low-tech device that could be made anywhere in the world: no electronics, no computers or filters are required,” says Dr. Fisher. “It’s almost inexplicable why we didn’t try this decades ago.”

The device was initially developed to treat carbon monoxide poisoning and in 2019 the FDA approved ClearMate as a marketable treatment for this following several clinical studies showing the device to be effective.

The new research, published in the journal Scientific Reports, describes a very small proof-of-concept experiment testing the ClearMate device’s ability to eliminate alcohol from a human body. Five subjects were recruited for the study.

Each subject underwent two experimental days, one testing the rate of blood alcohol clearance through normal ventilation and the other testing the rate using Clearmate for up to three hours. Each subject consumed a vodka-based drink to bring their blood alcohol up to 0.1 percent before commencing the experiment. The study found hyperventilation increased blood alcohol elimination rates more than three-fold.

The researchers note more work is needed to better validate the findings but it is suggested this could be applied to clinical settings as a kind of acute treatment for alcohol intoxication. Fisher and several other researchers working on the project have founded a company called Thornhill Medical to commercialize the ClearMate technology.

While the findings do effectively demonstrate how controlled hyperventilation can speed up the body’s ability to clear out alcohol, it is unclear whether this method could be usefully clinically deployed. It has previously been found clinically useful for carbon monoxide poisoning but it is difficult to envision how a semi-conscious subject suffering from acute alcohol poisoning could actively hyperventilate for up to three hours.

In the study, the researchers do hypothesize heavily intoxicated patients could be administered the treatment via endotracheal intubation. It is suggested with manual ventilation, in a critical care setting, blood alcohol levels may be reduced to below a lethal range in less than 40 minutes.

The new research was published in the journal Scientific Reports.

Source: University Health Networks

EEG response to hyperventilation in patients with CNS disorder

The mechanism of EEG (electroencephalography) alterations caused by forced breathing (hyperventilation test during functional loading) cause of high amplitude slow wave activity (paroxysmal synchronization) and development of epileptiform discharge has not been fully clarified. Different types of pathologic EEG reactions to hyperventilation hamper their interpretation, while the study of these phenomena is still of current interest. The goal of the investigation was to study and describe the EEG response to hyperventilation according to onset time of reaction and the pathological type of EEG. 2186 patients, who applied to D. Tatishvili Medical Center for examination, were recruited according to the EEG response to hyperventilation Based on the analysis of the results, 3 types of pathological EEG reactions/responses (PERH) (which have been revealed predominantly at the first minute of functional loading (P<0,05). The background rhythm of the EEG was restored within 2 and /or more minutes after the termination of loading. In 985 subjects 3 types of PERH have been revealed: First type of EEG reaction represents disorganization of the baseline rhythm, without paroxysmal reaction. Second type of EEG reaction reveal generalized, high-amplitude, monomorphic/polymorphic slow-wave paroxysmal discharges without epileptiform activity. Thirst type of EEG reaction reflects the epileptiform activity with and without generalized paroxysmal discharge. The EEG changes based on hyperventilation are linked to hypocapnia and concurrent acute alkalosis. It should be noted that partial pressure of carbon dioxide reduces to a minimum 1.5-2 minutes after hyperventilation, while pathologic changes in the EEG (paroxysmal EEG synchronization and/or generalized epileptiform discharges) are observed at the beginning of forced breathing. Such time incompatibility leads to search of alternative mechanisms that could more adequately explain the abovementioned phenomenon. We hypothesize to consider set of views developed by “hormesis theory”. Hyperventilation causes a mild stress; which induces the appearance of PERH at the beginning of forced breathing

electroencephalography, hyperventilation, epileptogenesis

The experience of modern medical practice has shown that, regardless of the intensive development and introduction of neuroimaging methods, electroencephalography (EEG) remains important. It is one of the most widely used methods of instrumental diagnostics of the CNS functional state in clinical and scientific studies [1-3]. EEG has proved to be more reliable (compared to the neuroimaging methods) in the diagnosis of epilepsy as well as of ischemic, degenerative, and inflammatory diseases of the brain (e.g. encephalopathy). It is also important that this method gives the possibility to evaluate the treatment efficacy in EEG- documented epilepsy and encephalopathy [4,5]. According to the International Guidelines, the procedure of EEG recording involves both the background activity and functional testing (photo-stimulation and hyperventilation). One of the most mandatory loads in clinical encephalography is the hyperventilation test involving the forced breathing for 3 min [6,7] or 3-5min. [8,9]. In healthy subjects this procedure causes a diffuse deceleration of the basic rhythm on the EEG [10,11]. In the patients with epilepsy, especially in those with absence seizures, hyperventilation provokes generalized epileptiform discharges [2,10]

The mechanism accounting for the origin of the changes in the EEG caused by hyperventilation, in particular, high amplitude slow wave activity (paroxysmal synchronization), has not been fully identified until now. Consequently, the existing conclusions concerning the influence of hyperventilation on the bioelectrical activity of the cerebral cortex are controversial. According to some authors [11-13], the cause of slow wave occurrence is the impairment of cerebral circulation due to hypocapnia and associated acute alkalosis, which leads to an inadequate oxygen and glucose supply to the brain. Other authors think that hyperventilation affects the brain potential both in humoral and reflex ways by means of the of blood vessel chemoreceptors [14], which causes reticular deactivation of the brain stem. This, in turn, leads to the modulating influence on the cerebral cortex [11,12]. Based on the literature, the hyperventilation test exhibits the changes in the EEG from the first minutes of recording [11,12], while the aforementioned alterations regarding hypocapnia develop and reach the peak later [15-17]. Such incompatibility in time of the characteristics of the phenomena considered makes it necessary to search for alternative mechanisms that more adequately explain the deceleration of the EEG basic rhythm from the first minutes of hyperventilation and the causes of enhanced epileptogenesis. The aim of the investigation is to study and describe the EEG response to hyperventilation according to the reaction onset time and the type of pathologic EEG. Based on all of the above, the goal of the study is:

1. Description and account of the reaction developed in response to hyperventilation

2. Distribution of subjects with the reaction to hyperventilation into groups according to gender and age.

3. Determination of the reaction time (reaction at 1st, 2nd, and 3rd minute) in different age groups.

2186 patients, 1139 females and 1047 males aged 3 to 51 years, who applied to D. Tatishvili Medical Center for examination in 2009-2014, were recruited according to the EEG response to hyperventilation. The control group consisted of 1201 participants whose EEG reaction/response to hyperventilation was within the normal range while the number of those with pathologic EEG reaction/response to hyperventilation (PERH) was 985. The subjects with PERH were subdivided into the following age groups: 3-6, 7-12, 13-18, 19-30, 31-50, 50 and over years. The participants under study had different functional disorders of the CNS (headache, fatigue, attention-deficit disorder, drowsiness sleep disorders, unstable arterial pressure, encephalopathy, epilepsy, ADHD etc.)

The study was conducted in a screened, soundproof room at a temperature of 22°C in a state of calm sleep at one and the same time of the day (11 am-1 pm). The first EEG recording was carried out with the purpose of estimating the background activity with closed eyes which lasted for 5minutes, then with open eyes (5 min) and again with closed eyes (5 min). Hyperventilation lasted for 3 minutes, while breath holding (15-25 sec.) was done after the cessation of hyperventilation. The duration of EEG recording was 25-35 minutes.

After performing the Fourier transform, the EEG frequency component analysis was done within the following range: delta (0.5-4.0 Hz), theta-1 (4.0-6.0 Hz), theta- 2 (6.0-8.0 Hz), alpha (8.0-13 Hz), beta-1(13-24 Hz), beta-2 (-50.8 Hz). EEG recordings were performed using 24-32 channel computer electroencephalograph” ENCEPHALAN MEDICOM”, with electrode location according to the International System 10-20, amplifier conductivity range 0.5-100 Hz, filtration frequency 50 Hz. the outputs being 3 db down at these frequencies. The signals from each input electrode were digitized with sampling rate of 256 Hz with the resolution of 12 bits. Electrode (Ag/AgCl) specific resistance was <5 KOhm and >1 KOhm for all electrodes. EEG was stored on a hard disk for off-line analysis.

The reliability (authenticity) of the results was estimated using the SPSS 20.0 program for statistical processing.

Based on the analysis of the data obtained, pathologic reaction to hyperventilation (PERH) was revealed in 985 subjects, which made up 45% of the total number of subject (2186). The distribution of the subjects according to the numerical and percentage indices into different age (3-6, 7-12, 13-18, 19-30, 31-50, 50 and over years) (Figure 1, Table 1) and gender (553 females and 432 males) (Figure 2, Table 2) groups are shown in tables and diagrams.

Figure 1. Quantitative and percentage data of individuals with pathological EEG-reactions on hyperventilation (PERH) in different age groups

Figure 2. Quantitative and percentage data of subjects with PERH according to gender

Table 1. Quantitative and percentage data of individuals with pathological EEG-reactions on hyperventilation (PERH) in different age groups

Table 2. Quantitative and percentage data of subjects with PERH according to gender

The manifestation of pathological reaction to hyperventilation (PERH) in time, implying the time point of the reaction occurrence, 1st, 2nd, 3rd minute, is shown in the tables and diagrams (Figure 3, Table 3). It should be noted that (PERH) is observed at 1st, 2nd, and 3rd minutes of the forced breathing onset. Figure 3 shows that at the 1st minute of hyperventilation PERH is revealed (in numerical and percentage terms) in 86% (853), at the 2nd minute in 9.4% (95) and at the 3rd minute in 3.8% (37) of the subjects.

Figure 3. Quantitative and percentage data of PERH on the first, second and third minutes

Table 3. Quantitative and percentage data of PERH on the first, second and third minutes

Three types of pathologic reaction to hyperventilation (PERH) have been revealed: Type 1 reaction (PERH-1) -73.1%/720) consists in the disorganization of the basal rhythm, which is manifested in the development of insufficiently regular alpha activity of high amplitude and mean index as well as of individual theta and delta waves without paroxysmal reaction (Figure 4, Table 4).

Figure 4. The quantitative and percentage indicators of a particular type of PERH

Table 4. The quantitative and percentage indicators of a particular type of PERH

Type 2 reaction (PERH-2) 2 -23.2%/229 subjects) develops in the form of generalized, high-amplitude, monomorphic or polymorphic slow-wave synchronous paroxysmal discharge without epileptiform Elements (Figure 4, Table 4).

Type 3 reaction (PERH-3) – 3.7%/36 subjects) causes epileptiform activity both in the form of generalized paroxysmal discharge and as separate grapho-elements (sharp waves, single spikes, and spike-wave complexes) (Figure 4, Table 4).

The results of the study have shown two types of the response to hyperventilation: normal (55%) and pathologic (45%), which was also described by other [18,19]. The normal reaction(response) consists in a diffuse deceleration of the basic /baseline rhythmicity of the EEG: the revealed slow- wave activity (capable of inducing EEG synchronization) is referred to as hyperventilation synchronization which is considered as a norm in all age groups [20] It should be noted that a prerequisite for asserting a normal physiologic response to hyperventilation is a rapid restoration of the background rhythm within one minute after the termination of the test [20,21]. An EEG recorded without changes in response to hyperventilation is a physiological reaction which is also considered the norm [12,22]. In the current study both types of responses (the norm) made up 55% of the total contingent.

Different types of abnormal (pathologic) EEG reactions to hyperventilation are problematic for the interpretation [10,11]. The mechanisms of alterations in hyperventilation-induced EEG, particularly with high-amplitude slow-wave activity (paroxysmal synchronization) have not been completely clarified.

There is an assumption [23], that the cause of the development of slow waves is the impairment of cerebral circulation due to hypocapnia and associated acute alkalosis [24] which results in insufficient oxygen and glucose supply to the brain.

The data regarding the influence of carbonic acid on EEG (in normal respiration) are controversial. Carbonic acid acts on the brain potential both through humoral and reflex way by means of the of blood vessel chemoreceptors [14,15], which causes the excitement of the brain stem reticular formation. This, in turn, leads to the modulating influence on the cerebral cortex (arousal, EEG desynchronization).

Regarding the origin of the EEG alterations revealed at forced breathing, these events seem urgent and require further investigation. Hypocapnia that develops in response to hyperventilation causes the deactivation of the brain reticular structure [25], which is manifested on the EEGs by the following changes: dysrhythtmia, hypersynchronization, different types of slow-wave and paroxysmal activity (with or without epileptic seizure). These patterns of pathologic EEG responses were observed in 985 subjects.

Based on the preliminary data, it is obvious that the three types of responses to hyperventilation PERH are mostly observed at the first minute of functional loading while restoration of the background rhythmicity occurs 2 or more minutes after the termination of the test [20,21].These findings are consistent with the data of other authors [11,26] whose note that EEG changes are observed at the beginning of forced breathing at the first minutes of hyperventilation. Accordingly, the prolongation of the experiment for another 2 minutes is inadvisable and especially dangerous for children.

To a certain extent, the explanation of the processes occurring in the brain at the background of (during) hyperventilation was given above and can be imagined (interpreted) as follows: the fall/drop of the partial pressure of carbon dioxide causes hypocapnia and subsequent vasoconstriction followed by cerebral ischemic anoxia. The concurrently developing respiratory alkalosis is accompanied by the shift (change) in oxygen dissociation curve (Bohr effect) and a decrease in ionized Ca⁺⁺ [12]. Presumably, such a complex of changes causes deceleration of the EEG. It should be mentioned that this hypothesis has a significant drawback: the partial pressure of carbon dioxide reduces to a minimum 1.5-2 minutes after the beginning of the experiment, while changes in EEG (paroxysmal EEG synchronization and/or generalized epileptiform discharges) are revealed) with the onset of forced breathing. Such incompatibility in time of the events considered makes it necessary to search for alternative mechanisms that may more adequately explain the deceleration of the EEG baseline rhythm from the first minutes of hyperventilation and the causes of enhanced epileptogenesis.

The reasonable is to consider a set of views developed by “hormesis theory”. In particular, it studies the mechanisms of weak stressor- stimulated effects on the body at an early stage of action.

The term hormesis was introduced in 1943 by C. Southam and J. Ehrlich, [27], however this theory has received special attention and definite scientific recognition in the last two decades [27-30]. Hormesis represents a paradoxical stimulation , i.e. low doses (intensity) of different substances and factors cause positive influence on the organism, while high doses of these substances are harmful [31,32]. The main agents of hormesis are: different types of radiation, effects of temperature, heavy metals and some drugs, as well as a short- term exposure of cells and the whole organism to chemical, physical or psychological (stress) impacts. Presumably, hyperventilation causes low stress which may stimulate the appearance of PERH at the beginning of forced breathing. Particularly, the detection of pathologic EEG developing at the first minutes of hyperventilation is probably associated with the effect of hormesis. This view is supported by the following consideration: respiration is the exception of autonomic function that is controlled voluntary. Any person can stop or start breathing faster. This is possible because the respiratory function is controlled by both autonomic and somatic nervous systems. The Respiratory System, due to these particular features becomes especially sensible to different factors (stress, fear, overwork) affecting psycho-somatic, nervous and psychic spheres of the organism. At that, it should be taken into account that individual specificity of PERH (occurrence, detection time and degree during functional loading) may be conditioned by the individual sensitivity of the subjects to a mild stress and a decrease in partial pressure of carbon dioxide. Based on all of the above, it is not easy to distinguish which of the impacts is paramount, determinative and/or particularly significant. This, in turn, makes it difficult to interpret every single pathologic EEG response to hyperventilation, which necessitates the extension of (further) studies.

1. Three types of pathological EEG reaction to hypoventilation have been revealed: disorganization of baseline rhythmicity, generalized, high-amplitude, monomorphic or polymorphic slow-wave paroxysmal discharges and epileptiform activity.

2. Pathological reactions to hyperventilation are predominantly revealed at the first minute of loading, which is diagnostically informative. Therefore the extension of functional loading is not advisable/ recommendable, especially in patients with different disorders and in children.

3. The appearance of pathological EEG reactions/responses to hyperventilation could not be explained only based on hypocapnia, due to it develops later on. We think it reasonable to consider a set of views developed by “hormesis “ theory. In particular, the stimulating effects of low stress on the body in/at the early stages of their impact.

1. Binnie CD, Stefan H (1999) Modern electroencephalography: its role in epilepsy management. Clin Neurophysiol 110: 1671-1697.
2. Kane N, Grocott L, Kandler R, Lawrence S, Pang C (2014) Hyperventilation during electroencephalography: safety and efficacy. Seizure 23: 129-134.
3. Mendez OE, Brenner RP (2006) Increasing the yield of EEG. J Clin Neurophysiol 23: 282-293.
4. Fisch B (2006) Fisch and Spehlmann’s EEG primer Basic principles of digital and analog EEG. Elsevier, Germany pp: 7-12, 621.
5. Niedermeyer E, Lopes de Sylva F (2005) In: Electroencephalography: basic principles, clinical applications and related fields. Lopes de Sylva F (ed) Lippincott Williams & Wilkins, Philadelphia, USA pp: 684-687.
6. Angus-Leppan H (2007) Seizures and adverse events during routine scalp electroencephalography: a clinical and EEG analysis of 1000 records. Clin Neurophysiol 118: 22-30.
7. Yenjun S, Harvey AS, Marini C, Newton MR, King MA, et al. (2003) EEG in adult-onset idiopathic generalized epilepsy. Epilepsia 44: 252-256.
8. Adams DJ, Lueders H (1981) Hyperventilation and 6-hour EEG recording in evaluation of absence Seizures. Neurology 31: 1175-1177.
9. Craciun L, Varga ET, Mindruta I, Meritam P, Horváth Z, et al. (2015) Diagnostic yield of five minutes compared to three minutes hyperventilation during electroencephalography. Seizure 30: 90-92.
10. Guaranha MS, Garzon E, Buchpiguel CA, Tazima S, Yacubian EM, et al. (2005) Hyperventilation revisited: Physiological effects and efficacy on focal seizure activation in the era of video-EEG monitoring. Epilepsia 46: 69-75.
11. Glukhova L, Mukhin K, Nikitina M, Barletova E, Tupikova E (2013) The importance of electroencephalographic activating methods in clinical practice of neurologist. Russ J Child Neurol 8: 15-30
12. www. neuronet.ru/bibliot/b002/hv. html
13. Hayashi K, Fujikawa M, Sawa T (2008) Hyperventilation-induced hypocapnia changes the pattern of electroencephalographic bicoherence growth during sevoflurane anaesthesia. Br J Anaesth 101: 666-672.
14. Brian JE (1998) Carbon dioxide and the cerebral circulation. Anesthesiology 88: 1365-1386.
15. https://www.liverpool.ac.uk/~gdwill/hons/gul_lect.pdf
16. www.psychologicalharassment.com/acidbase-balance.html
17. https://nirvana.fitness/breath-control-regulation-of-respiration-o2-vs-co2-20-10-2015.html
18. Siddiqui SR, Zafar A, Khan FS, Shaheen M (2011) Effect of hyperventilation on electroencephalographic activity. JPMA 61: 850.
19. Srinivasulu N, Shashikala K, Srinivasa R (2014) Nonspecific abnormal EEG patterns during hyperventilation test on the electroencephalogram of normal and epileptic patients. RRJMHS 3: 92-97.
20. Fish B and Elson L (2003) Activation methods Current practice of clinical electroencephalography. Ebersole JS, Pedley TA (eds) Lippincott Williams & Wilkins, Philadelphia, USA pp: 246-270.
21. Blagosklonova NK (2000) In: Clinical electroencephalography, (in Epileptology of childhood) Manual for doctors. Petrukhin M (ed) pp: 309-406.
22. Fisher R (2011) In: The Johns Hopkins Atlas of Digital EEG. Kraus G, Kaplan P (ed) The Johns Hopkins University press, Maryland, United States pp: 711-761.
23. Van der Worp HB, Kraaier V, Wieneke GH, Van Huffelen AC (1991) Quantitative EEG during progressive hypocarbia and hypoxia. Hyperventilation-induced EEG changes reconsidered. Electroencephalogr Clin Neurophysiol 79: 335-341.
24. Morrison V, Chesnokova N, Bizenkova M (2015) Typical violations of the acid-alkaline state. Int J App Fund Res 3: 273-278.
25. Son S, Kwon OY, Jung S, Kim YS, Kim SK, et al. (2012) Relationship between hyperventilation-induced electroencephalographic changes and PCO₂ level. J Epilepsy Res 2: 5.
26. Litchfield P (2008) The Brain-Breath Connection: Breathing Chemistry and its Effects on Neurophysiology, Emotion, Cognition, Personality, performance and Health https://www.futurehealth.org.
27. Calabrese EJ (2008) Dose-response features of neuroprotective agents: an integrative summary. Crit Rev Toxicol 38: 253-348.
28. Calabrese EJ (2016) Preconditioning is hormesis part I: Documentation, dose-response features and mechanistic foundations. Pharmacol Res 110: 242-264.
29. Calabrese V, Cornelius C, Cuzzocrea S, Iavicoli I, Rizzarelli E, et al. (2011) Hormesis, cellular stress response and vitagenes as critical determinants in aging and longevity. Mol Aspects Med 32: 279-304.
30. Calabrese V, Giordano J, Crupi R, Di Paola R, Ruggieri M, et al. (2017) Hormesis, cellular stress response and neuroinflammation in schizophrenia: early onset versus late onset state. J Neurosci Res 95: 1182-1193.
31. Murado MA, Vázquez JA (2007) The notion of hormesis and the dose–response theory: a unified approach. J Theor Biol 244: 489-499.
32. Yoshimasu T, Ohashi T, Oura S, Kokawa Y, Kawago M, et al. (2015) A theoretical model for the hormetic dose-response curve for anticancer agents. Anticancer Res 35: 5851-5855.

Hyperventilation | Encyclopedia.com

hyperventilation The ventilation of the lungs is the volume of air breathed in (and out) per minute. Hyperventilation means that this volume is excessive, such that carbon dioxide is lost from the lungs at a greater rate than it is being produced by metabolism in the body.

The term ‘hyperventilation’ does not apply to the increases in breathing that meet appropriately the varying demands of movement, work, and exercise. In the alveoli, in the depths of the lungs, when breathing changes involuntarily to meet these needs, there is very little change in the average concentrations of oxygen and of carbon dioxide. These concentrations are such that the blood, after exposure to them, leaves the lungs with its oxygen topped up to full saturation (however much has been removed during circulation around the body) and its carbon dioxide reduced to the concentration which is normal for arterial blood (however much has been added).

Now, deliberately, take a few extra deep breaths: in the lung alveoli the concentration of oxygen is immediately increased, and that of carbon dioxide decreased. This cannot load more oxygen into the blood, because the oxygen concentration in the lungs was already sufficient to saturate the oxygen-carrying capacity of its haemoglobin. However, what this over-breathing can and does do, very readily, is to remove more carbon dioxide. Then there is less of it in the blood leaving the lungs, and hence less in the arterial blood; and after a few more deep breaths, less everywhere in the body, because carbon dioxide diffuses readily in and out of body fluids and cells. But if attention is now diverted from breathing, any small decrease which has been imposed on the carbon dioxide level in the blood will have been detected by the chemoreceptors, leading to a reflex decrease in breathing which rapidly restores the blood carbon dioxide to its normal level.

What, then, happens if hyperventilation — deliberate over-breathing — is continued? The ‘wash-out’ of carbon dioxide progresses, from the lungs, and hence from the blood, and from the body tissues including, importantly, the brain. Carbon dioxide is a crucial variable in acid–base homeostasis; its reduction shifts the body fluids towards greater alkalinity (increased pH) and this has further knock-on effects. For one thing, it tends to cause constriction of some blood vessels, particularly those in the brain, reducing its blood supply and therefore its oxygen supply. So, in what might seem the midst of plenty when an excess of air is being shifted in and out of the lungs, the brain can actually be short of oxygen. It is for this reason that persistent, vigorous over-breathing soon makes us feel faint and dizzy. Another result of the alkalinization of the blood may be tetany: an uncontrollable twitching (caused by neuromuscular over-excitability consequent upon an increase in the binding of calcium ions to proteins in the plasma).

All of this implies that the measureable criterion of hyperventilation is lower-than-normal carbon dioxide in the blood. (This is usually expressed as the ‘PCO₂’, representing the partial pressure of carbon dioxide gas with which a sample of blood would be in equilibrium.) In most circumstances, in healthy people, the involuntary breathing control mechanisms keep the PCO₂ in arterial blood at the normal level, or bring it quickly back to that level following any disturbance.

There are, however, circumstances when other vital physiological adjustments take precedence over maintaining the normality of the arterial blood carbon dioxide. In these instances the body’s reflex control of breathing itself results in hyperventilation. One of these circumstances is high-altitude hypoxia. When the pressure of oxygen in the inhaled air is too low to saturate the haemoglobin in the blood, an increase in breathing gains a little higher concentration of oxygen in the lungs, at the expense of decreasing the carbon dioxide. Some resulting disturbance of acid–base balance can be tolerated, and compensated for if exposure is prolonged. A second circumstance is an increase in blood acidity, such as occurs due to production of lactic acid in strenuous exercise, or of other acids in starvation. This disturbance is countered by reflex hyperventilation, causing a shift back in the alkaline direction by washing out carbon dioxide.

Short-term, minor degrees of hyperventilation can occur without conscious intention as an aspect of anxiety: adrenaline and other components of the stress response can also stimulate breathing. Airplane pilots, for example, have been reported to hyperventilate during landing procedure, and it is a common experience to be aware of overbreathing in some demanding situations. More seriously, full-blown ‘panic attacks’ are likely to be accompanied, and aggravated, and some would say caused, by hyperventilation.

There has been considerable medical interest, research, and some controversy in recent decades concerning the so-called hyperventilation syndrome(s). Certainly some people hyperventilate habitually, for reasons that are usually unclear, but that have been linked to psychological disorders. A wide variety of mental and physical symptoms have been attributed to such hyperventilation and its consequences, simulating other medical conditions, and even surgical emergencies. Improvement of health and well-being can follow a training regime to bring the breathing pattern back to normal.

Deliberate hyperventilation before breath-holding can extend the time before the breaking point at which the urge to breathe can be resisted no longer. It seems obvious that this is to be expected, simply because the more oxygen has been taken into the lungs the longer it will last. But it is not as simple as that, and the complexities are relevant to the potentially dangerous situation of over-breathing before diving or swimming underwater. The predominant factor that ends a breath-hold, by causing an overpowering drive to breathe, is a certain trigger level reached by the rising carbon dioxide; after overbreathing it takes longer to reach this trigger, because the starting level was lowered. But the overbreathing has not stored extra oxygen in the blood, so that it now has a longer time in which to go on being depleted. The result can be faintness or even unconsciousness, before the swimmer feels the need to surface. Although the progressive oxygen depletion itself also contributes to the drive to breathe in this situation, those individuals whose reflex response to oxygen lack is relatively insensitive may be at risk.

Sheila Jennett

See also breathing; carbon dioxide; chemoreceptors; diving; lungs; oxygen.

Hyperventilation

Hyperventilation raises the pH value of the blood by lowering the carbon-di-oxide concentration in the blood. This makes the blood more alkaline. It also brings about constriction of the blood vessels that supply the brain thereby restricting the transport of vital electrolytes that are required for the functioning of the nervous system.

Low concentration of carbon dioxide in the blood is known as hypocapnia a condition that causes the blood pH to rise and is referred to as a respiratory alkalosis. This high pH also causes lowering of calcium (called hypocalcemia) being available in the blood. Low calcium affects the nerves and muscles and causes tingling sensation in fingers and light headedness.

The body also has a habit of producing an acute shortage of carbon dioxide naturally. This situation is controlled by a centre in lower section of the brain which ensures that the normal level of carbon- di- oxide and oxygen remains balanced in the blood.

Although it may contradict earlier belief, excessive breathing can be counter productive and can result in a reduced oxygen supply to the brain. For this reason doctors sometimes artificially induce hyperventilation following a head injury in order to alleviate the pressure in the skull (it must be remembered that this method comes with its own set of risks).

Rapid or deep breathing may be observed in serious conditions including heart attacks or even rapid loss of blood that leads to a state of shock.

Hyperventilation lasts longer (few hours) than a heart attack and improves with exercise but does not improve with heart medications. Unlike heart attack, hyperventilation is more common in younger people.

Hyperventilation syndrome, on the other hand, is more specific and produces a group of symptoms. It also emerges in an individual under certain conditions. Although the symptoms closely resembles those of panic attacks, the two conditions are entirely different. Panic disorders are usually a result of an emotional problem while the symptoms of hyperventilation syndrome occurs even if no emotional complaint is present.

There are the two forms of hyperventilation syndrome that which occurs everyday and those that occur suddenly! The excessive breathing may be difficult to detect in the everyday form while in the sudden form the symptoms are more intense and manifests rapidly.

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Scientists have found a way to quickly clear blood from alcohol

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Scientists have found a way to quickly clear blood from alcohol

Scientists have found a way to quickly clear blood from alcohol – RIA Novosti, 12.11.2020

Scientists have found a way to quickly purify blood from alcohol

Canadian scientists have developed a simple and quick method of removing alcohol from the body, which does not require expensive equipment. Research results … RIA Novosti, 12.11.2020

2020-11-12T13: 00

2020-11-12T13: 00

2020-11-12T13: 33

science

alcohol

canada

health

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MOSCOW, Nov 12 – RIA Novosti. Canadian scientists have developed a simple and quick method of removing alcohol from the body, which does not require expensive equipment. The research results are published in Scientific Reports. Ethanol, present in all alcoholic beverages, when a certain level of concentration in the blood is reached, begins to act as a poison, disrupting the function of blood circulation, affecting the brain and other organs.According to the World Health Organization, about three million people die every year as a result of severe alcohol intoxication in the world. Up to 90 percent of alcohol from the human body is excreted by the liver at a constant rate that cannot be increased. Dialysis, intravenous fluids, and oxygen supply can slightly speed up the elimination of alcohol from the blood. Researchers at the University Health Network (UHN) in Toronto have suggested using the lungs to eliminate alcohol.Scientists have found that with hyperventilation – deep and fast breathing – alcohol is excreted three times faster than through the liver, and the stronger the breath, the more alcohol is excreted from the body. with forced exhalation, a person loses a lot of carbon dioxide, along with which alcohol is excreted. And the rapid decrease in this gas in the blood causes dizziness, fainting and numbness of the arms and legs. “You can’t just hyperventilate, because after a couple of minutes you will feel dizzy and you will lose consciousness,” the study leader, Dr. Joseph, quoted in a press release from UHN. Fisher, an anesthesiologist and senior research fellow at the Toronto General Hospital Research Institute.The authors have developed a compact, briefcase-sized device that maintains a patient’s blood carbon dioxide levels during hyperventilation. The equipment is very simple, it consists of a small reservoir of compressed carbon dioxide, several connecting pipes, a mask and a valve system. “It is a very simple device that can be easily manufactured anywhere in the world. It does not require electronics, computers or special filters. how we didn’t come to this a few decades ago, ”says Dr. Fischer.This study is the first practical evidence that baseline alcohol elimination can be significantly increased with hyperventilation, and the authors believe their vision will not only create new treatments for severe alcohol intoxication, but also help those who simply want to sober up quickly. During the study, the device was successfully tested by volunteers, but for industrial implementation, scientists say, it is still necessary to conduct full trials in a clinical setting.

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MOSCOW, November 12 – RIA Novosti. Canadian scientists have developed a simple and fast method for removing alcohol from the body, which does not require expensive equipment.The research results are published in Scientific Reports.

Ethanol, present in all alcoholic beverages, when a certain level of concentration in the blood is reached, begins to act as a poison, disrupting the function of blood circulation, damaging the brain and other organs. According to the World Health Organization, about three million people die every year as a result of severe alcohol intoxication.

Up to 90 percent of alcohol from the human body is excreted by the liver at a constant rate that cannot be increased.Dialysis, intravenous fluids, and oxygen supply can slightly speed up the elimination of alcohol from the blood.

Researchers at the University Health Network (UHN) in Toronto suggested using the lungs to remove alcohol. Scientists have found that with hyperventilation – deep and fast breathing – alcohol is excreted three times faster than through the liver, and the stronger the breath, the more alcohol is excreted from the body.

This technique was known to doctors before, but it was used to a limited extent, since with forced exhalation, a person loses a lot of carbon dioxide, along with which alcohol is excreted.And the rapid decrease in this gas in the blood causes dizziness, fainting, and numbness in the arms and legs.

September 9, 2020, 12:00 (Joseph Fisher), anesthesiologist and senior research fellow at the Toronto General Hospital Research Institute.

The authors have developed a compact, briefcase-sized device that maintains the patient’s blood carbon dioxide levels during hyperventilation. The equipment is very simple, it consists of a small reservoir of compressed carbon dioxide, several connecting pipes, a mask and a valve system.

“This is a very simple device that can be easily manufactured anywhere in the world. It does not require electronics, computers or special filters. It’s amazing how we didn’t come to this several decades ago,” says Dr. Fisher.

This study is the first practical evidence that the basal alcohol elimination rate can be significantly increased with the use of hyperventilation.

The authors believe that the concept developed by them will not only create new methods of treating severe alcohol intoxication, but also help those who just want to quickly sober up.

During the study, the device was successfully tested by volunteers, however, for industrial implementation, scientists say, it is still necessary to conduct full trials in a clinical setting.

25 May 2020, 18:00

Have you ever wondered how many breaths you take per minute? In a normal state, in 60 seconds a person produces an average of 16. Imagine a state when a person breathes several times more often, but does not receive oxygen saturation and thinks that he is suffocating. Doctors call a breathing disorder that exceeds the body’s need for oxygen, hyperventilation.Therapist Tatyana Ivanova and psychiatrist Oleg Banko told Segodnya about the diagnosis and treatment of hyperventilation syndrome, as well as about the consequences of ignoring the problem.

COUNTING INHALATIONS

In addition to difficulty breathing at the time of an attack, the clinical manifestations of DHW can be as follows:

– frequent sighs, shortness of breath, asthma attacks;

– anxiety;

– coughing attacks;

– increased breathing;

– headache, dizziness;

– unstable gait;

– chest pain;

– dry mouth;

– feeling of coldness in the limbs.

Symptoms can be especially pronounced during a panic attack, when the so-called hyperventilation crisis develops. Its signs are sweating, chills, heart palpitations, choking, sharp pain in the heart, nausea, fear of death, etc.

REASONS FOR OVERVENTILATION

An uncontrolled process of hyperventilation can be caused by one or a number of reasons.

1. Psychoemotional states: stress, phobias, attacks of hysteria, panic states, strong nervous overexcitement.
2. Excessive physical activity.
3. Chronic heart failure.
4. Allergic or inflammatory diseases of the respiratory system.
5. Attacks of severe pain for various reasons.
6. Alcohol or drug overdose.
7. Taking drugs, abuse of energy stimulants.

“Most often, hyperventilation occurs in a person against the background of a stressful situation or with a sharp physical exertion,” says Tatyana Ivanova.- Nevertheless, many patients claim that problems can arise out of the blue, but it is very difficult to establish the authenticity of this statement. The fact is that, once having experienced a severe attack of suffocation, people are subconsciously very afraid of a repetition of the situation. So, if the first time hyperventilation was caused, for example, by severe pain as a result of a blow, then the second time it can be caused by any picture that will be associated with that case – the room in which the attack occurred, loud music playing at that moment, or clothes that were then on the person. “

RECOMMENDED FOR PATIENTS WITH DHW:

• Stop drinking coffee, alcohol and smoking.
• Regularly do breathing exercises on the recommendation of the attending physician, developing the correct depth and frequency of breathing – it should be carried out against the background of mental relaxation and positive emotions.
• Refuse from taking medications, taking narcotic or overly stimulating drugs.
• Correctly alternate work and rest.

WORKING WITH EMOTIONS

At first glance, each of the manifestations of hyperventilation syndrome is harmless in itself. And in the aggregate, these symptoms do not cause concern if breathing can be restored within a few minutes. But this does not always happen, therefore, if for a long time it is not possible to calm down and return to normal breathing, an urgent need to call a doctor. As a result of prolonged (up to two hours) continuous intensive hyperventilation, deep pathological changes in the tissues of organs can occur, spasms of large vessels appear, which is fraught with heart attacks and extensive strokes.

“But it is necessary to seek help from a specialist not only in critical situations,” warns Tatiana Ivanova. may need a cardiogram, chest x-ray, or computed tomography. ”

CURE THE CAUSE. DHW treatment will initially address the underlying causes.If the problem lies in the pathologies of the body, appropriate treatment will be prescribed with further supervision.

Most often, the disease is provoked by deviations of the human mental sphere. In this case, the path to recovery will lie through the psychiatrist’s office, who must understand the patient’s condition and determine what brings him to such a state. In the future, working with the psycho-emotional background of a person, the doctor can prescribe medications (including antidepressants with a tranquilizing effect) and a number of health procedures.

“Children and adolescents are especially susceptible to the treatment of DHW caused by neuroses and other emotional states,” says Oleg Banko. “It’s easier to convince them of the curability of the disease, teach them to calm down and regulate their breathing on their own. After a while, the symptoms go away forever. With patients. older people are more difficult, if only because it is very difficult for them to relax and achieve the truth about their worries and fears. ”

Read also:

90,000 “Balloons must not be inflated.”How Lungs Recover After Coronavirus | HEALTH: Medicine | HEALTH

After the summer lull, the incidence of coronavirus is on the rise again. Conserved mono hospitals are reopening, and residents are asked to be more attentive to their own safety and not to neglect protective masks and antiseptics. The disease is difficult for many, and recovery can take more than one year. A lung rehabilitation program has been developed in Tyumen especially for patients with covid pneumonia.Why diaphragmatic breathing is difficult for women and why throat singing is needed, the correspondent of “AiF – Tyumen” learned.

No coughing, no loss of smell

In July 53-year-old Evgeny Falov fell ill, despite signs of rotavirus infection, his daughter-doctor insisted on seeing a doctor. During a pandemic, any malaise makes you alert. And, as it turned out, not in vain. Computed tomography showed pneumonia with lung involvement of 8%, although there was no cough, runny nose, or loss of smell.And even the coronavirus test was negative. After prescribing the treatment, the man was sent home, making an appointment in a week. Repeated admission showed – it only got worse, the percentage of lung damage increased to sixteen. Evgeny Evgenievich was admitted to the mono-hospital of the Regional Clinical Hospital No. 1. A week later, he was already in the intensive care bed. Pneumonia developed rapidly, from 16% in seven days, lung damage increased to 53%.

The man was in intensive care. Photo: Ministry of Health RD

“The doctors did their best, but it didn’t get any better.Shortness of breath began, it became hard to breathe, the cough was very strong. Relatives began to look for a person who had had a coronavirus with the same blood group as mine in order to try a blood transfusion with antibodies. My daughter’s colleague, a urologist, responded. On Monday he donated blood, they were already preparing for a transfusion, but the next day, for the first time in a long time, my temperature did not rise. I went on the mend, I hope the blood with antibodies saved the life of another person, – says Evgeny Falov. “The week I spent in the mono hospital seemed like an eternity.Faced with the virus, we realized how insidious and unpredictable it is. It is scary to imagine what could have happened if the daughter had not immediately insisted on going to the doctors. From the bottom of my heart I would like to thank all the doctors, nurses of department No. 4 of the single hospital of OKB No. 1. Wearing protective suits, respirators day and night, they fight for the life and health of every patient. And the townspeople sometimes ignore requests to wear protective masks in public places. Just masks that you can take off by getting into your own car, going home. “

Evgeny Evgenievich spent 21 days in the mono-hospital. Now his lungs are affected by 20%. He walks a lot in the coniferous forest, does special breathing exercises. It can take a year or more to fully recover.

Special gymnastics

At the beginning of August, on the basis of OKB No. 1, a rehabilitation course “Free breathing” was launched especially for those who had suffered from coronavirus. Observation of covid pneumonia has shown that such patients need a special approach.

“Structural changes begin in the lungs, mostly fibrous, when the lung tissue is scarred. This leads to impaired respiratory function. The elasticity and extensibility of tissues decreases, the permeability of oxygen and carbon dioxide becomes difficult. The more this process, the more extensive the damage to the lungs and the longer it will take for rehabilitation. In any case, this is not a matter of a couple of months, on average it takes a year to recover, or even more. It all depends on the immunity, the patient’s lifestyle, ”says Yulia Khazeeva , doctor of exercise therapy at OKB No. 1, .

Special gymnastics. Photo: Regional Clinical Hospital No. 1, Tyumen Oblast State Budgetary Healthcare Institution

Rehabilitation is needed for everyone who has suffered from covid pneumonia, even if the lungs are slightly affected. According to Yulia Khazeeva, pneumonia in coronavirus differs from ordinary pneumonia primarily in that it can be asymptomatic. The person feels well, he does not have a high fever, cough, headaches, sensation of a foreign body in his chest, and with computed tomography it turns out that the lungs are inflamed.Without proper treatment and recovery, organ damage only gets worse.

“Patients do not know what exercises are needed, how to do them correctly, how to breathe in order to restore their lungs,” explains the doctor. “Therefore, pulmonologists have developed a ten-day rehabilitation course with special exercises. We tell, show, explain, so that later they can independently perform breathing exercises at home. ”

We sing like Tuvinians

Physiotherapy, massages, breathing exercises – for ten days, patients learn diaphragmatic breathing and even throat singing.In one complex, five procedures are less complicated, in the second – the same number, but more difficult.

“With the history cathedral, we see what part of the lung in a person is affected, depending on this, we select an individual set of exercises in order to influence the affected section. The initial position of the exercise works precisely for this lobe: on the back, on the side, with a roller under the chest, etc., the exercises are not technically difficult. Difficulties arise only with diaphragmatic breathing. As a rule, this is a male type of breathing, it is difficult for women to master it.And it is necessary to work out the lower lobes of the lungs, ”the doctor shares.

Pulmonologists warn patients against training their lungs by inflating a balloon. Photo: pixabay.com/

One of the most effective exercises is sound vibration gymnastics. It is similar to Tuvan throat singing, only you need to “lower” the sounds into the chest region so that from a drawn-out “y” it vibrates in the lungs. The letter “y” has a good effect on the elasticity of the lung tissue and helps to gently get rid of fibrosis. And the long “p” works like a drainage system.If patients complain of a foreign body sensation in their chest, it becomes easier for them to breathe after the “growl”. Patients also learn to sing and breathe correctly at home; a set of exercises must be repeated three times a day. The most important thing in breathing exercises after covid pneumonia is caution and slowness. For the same reason, pulmonologists warn patients against training their lungs by inflating a balloon. This leads to a sharp increase in lung volume and hyperventilation, which is completely undesirable after pneumonia from coronavirus.

90,000 Breathe – don’t breathe. What Happens to the Brain When We Hold Our Breath

The idea for the study, published in the European Journal of Applied Physiology , was born out of the practical work of Irina, a freediving coach – free scuba diving. Freediving athletes dive in the pool or in the sea. At competitions, holding their breath, they lie quietly, swim as far as possible or dive as deep as possible.

“The world records are fantastic – holding your breath for more than 11 minutes at rest, 200 meters long in the pool and 217 meters deep.But what happens in the body at this time has not yet been fully studied, the long-term effects are also not clear, ”said Irina.

Stefan Mifsud sets the world record for holding his breath: 11 minutes 35 seconds

The longer the holding time lasts, the more carbon dioxide accumulates in the blood, and the oxygen content decreases. The researchers suggested that in such conditions, the work of the brain may change: the speed of reactions and thought processes will decrease, and attention will deteriorate.

How long can you not breathe

The study compared the results of two groups of subjects: 13 professional freedivers and nine people without special training. One of the professional freedrivers held his breath for the longest time – for 5 minutes 45 seconds.

It is believed that an ordinary person can not breathe for about a minute, but during the research it turned out that this is not the case. If you explain to the participant in advance what awaits him and what sensations he will experience, then the time for holding the breath can be increased by removing the psychological barrier.Thanks to this, in the control group, the best result was 4 minutes 23 seconds.

Freediver training in the pool. Photo: Elina Manninen / Shutterstock

“If you know what happens to the body during breath holding, what to fear and what not, you can calmly perceive the unpleasant sensations and increase the breath holding up to 2-3 minutes. Until involuntary contractions of the diaphragm begin – reflex urge to inhale, there is nothing to fear, ”said Patricia Ratmanova.

What happens with prolonged breath holding

In order to assess the brain and body condition during breath holding, the researchers recorded an electroencephalogram, cardiogram, blood pressure, oxygen levels in the blood and brain tissues and other indicators.Immediately after holding their breath, the subjects were given a test for attention and hand-eye coordination – a proofreading test. Volunteers received a sheet with rows of letters printed in random order. Their task was to look through the letters and look for those that were named by the researchers. They had to underline one of the given letters, and cross out the other.

“We expected that brain function would deteriorate, but everything turned out to be completely wrong. Brain activity did not change, attention did not decrease – we did not find any negative changes, even with prolonged breath holdings, ”said Patricia.

Scientists have suggested that in humans, like in marine mammals (whales, dolphins, seals), the so-called “diving reflex” is triggered. It aims to protect the brain and heart from lack of oxygen.

A test subject of the control group during a study in the laboratory of physiology of muscle activity of the Institute of Biomedical Problems of the Russian Academy of Sciences. Photo courtesy of Patricia Ratmanova

During the “diving reflex” at the periphery of the body, the vessels constrict, which reduces blood flow to the muscles and oxygen consumption, increases blood pressure and slows the heart rate.As a result, blood mainly flows to the heart and brain. In the brain, blood vessels, on the contrary, expand, blood flow and oxygen supply to brain cells increase. As a result, the work of the brain does not suffer when holding the breath.

Meditation and Holotropic Breathwork

Nevertheless, breathing exercises can affect the functioning of the brain, sometimes this effect is positive, sometimes it is dangerous.

“The techniques used in meditation are usually associated with slowing down the breathing rhythm or holding the breath for a short time.Their main task is to help a person concentrate on the sensations of his own body, to distract himself from external stimuli. There is no harm from such breathing exercises, ”explained Patricia.

Hyperventilation, which, for example, underlies holotropic breathing, can be dangerous.

“When we breathe deeply and rhythmically, carbon dioxide is washed out of our blood. The body reacts to this by reflex vasoconstriction. As a result, despite deep breathing, the so-called cerebral hypoxia occurs – a lack of oxygen in the brain, ”said the researcher.

This can trigger an epileptic seizure in some people. “There are those who are predisposed to epilepsy and do not even know about it. Such people can live their whole lives without a single attack, if not provoked by hyperventilation. And after the epilepsy manifests itself for the first time, the seizures may recur, ”the scientist warned.

Ekaterina Borovikova

Scientists told about a way to quickly cleanse blood from alcohol | News | Izvestia

It is possible to remove alcohol from the body three times faster with the help of the lungs.This conclusion was made by scientists from the University Health Network (UHN) in Toronto. The study was published in Scientific Reports on Thursday, November 12.

Scientists recalled that 90% of alcohol is excreted by the liver. During the experiment, it turned out that with hyperventilation – deep and fast breathing – alcohol is excreted three times faster than through the liver, and the stronger the breath, the more alcohol can be excreted from the body.

“You can’t just hyperventilate, because in a couple of minutes you will feel dizzy and unconscious,” said study leader Dr. Joseph Fisher, an anesthesiologist and senior research fellow at the Toronto General Hospital Research Institute, in a UHN press release. …

The technique was known earlier, but it was used to a limited extent, since during forced exhalation, a person loses a lot of carbon dioxide, along with which alcohol is excreted. The rapid decrease in this gas in the blood causes dizziness, fainting, and numbness in the arms and legs.

In order to hyperventilate without worsening a person’s condition, the researchers have developed a briefcase-sized device that does this. The equipment consists of a small reservoir of compressed carbon dioxide, several connecting pipes, a mask and a valve system.

During the study, the device was successfully tested by volunteers – five physically healthy men. The concentration of ethanol in their blood was brought to a moderately elevated level – up to about 0.1%. The ethanol elimination process was monitored on different days during normal ventilation and hyperventilation. It turned out that isocapnic hyperpnea (IH) increased the rate of elimination of alcohol in proportion to its level in the blood, increasing the rate of excretion by more than three times.

This study is the first practical evidence that the rate of elimination of alcohol from the body can be significantly increased with the use of hyperventilation.

Scientists believe that the concept developed by them will not only create new methods of treating severe alcohol intoxication, but also help those who need to quickly sober up.

Researchers note that full clinical trials are required for commercial implementation.

In June, phytotherapist, candidate of biological sciences Mikhail Lushchik said that the fermented milk drink ayran, in addition to having a beneficial effect on digestion, can also help with a hangover.

According to him, as an acidic product, ayran increases the acidity of gastric juice, promotes the digestion of food and is easily absorbed.

Instruction for the patient with epilepsy | Ministry of Health of the Chuvash Republic

First aid for epileptic seizure

Patient with epilepsy. Advice for patients and their relatives.

Introduction

The first mention of epilepsy in the writings of Hippocrates more than 2000 years ago.The name epilepsy comes from the Greek word meaning literally “to possess”, “to seize.”

Epilepsy is a chronic disease of the brain, characterized by repeated, spontaneous (unprovoked) seizures in the form of impaired motor, sensory, autonomic, mental or mental functions resulting from excessive discharges of nerve cells in the cerebral cortex. Epilepsy can occur at any age, but it is more common in childhood and the elderly.This is one of the most common diseases of the nervous system, occurring in 0.5-1% of the population of developed countries. This means that about 50 million people worldwide have epilepsy.

Epilepsy is a treatable brain disease, and a number of errors and warnings associated with the diagnosis of epilepsy are still widespread in society. Patients still experience the burden of social stigmatization, which is especially typical in those countries where modern knowledge about epilepsy is not widespread in society and in the medical environment.Patients are faced with limitations in various spheres of life, including when looking for a job, in the learning process. Often, in order to avoid social stigmatization, patients hide the diagnosis, which can lead to irreparable consequences that threaten the patient’s health and life.

At present, on average, 65-70% of patients may experience complete cessation of seizures. In this case, lifelong therapy is not always required, and in many cases, gradual withdrawal of the drug is possible in the future.The quality of life of patients with epilepsy has also significantly improved.

Helping a patient during an attack.

1. If the patient has a premonition of an attack, should he take the necessary safety measures? Lie on a bed or on the ground, away from traumatic objects, loosen your tie (for men). The child should be placed on a flat bed or on the floor, and tight clothing, especially at the throat, should be unbuttoned or loosened to clear the airway. Outside the home, the child must be moved to a safe place (away from water, traffic, sharp objects and corners), put something soft under his head (for example, a rolled up jacket, jacket).It is necessary to protect the patient from injury, especially head injury.

2. If a convulsive attack occurs suddenly and the patient does not anticipate it, he himself cannot protect himself from injury, and precautions must be taken after the onset of the attack. During an attack, the patient should not be carried, except in those cases when he may be in danger, for example, on the roadway, near a fire, on stairs or in the water.

3. In case of increased salivation and vomiting, the patient must be placed on his side so that he does not choke.This should be done gently, without using force.

4. Do not try to hold the patient by limiting his movements. Also, you do not need to try to open the patient’s mouth, even if the tongue is bitten: this can lead to injury to the teeth, mucous membranes of the mouth and tongue. Remember that when the head is on its side, tongue retraction never occurs and recommendations for unclenching the jaws, pulling out and even fixing the tongue are not justified and harmful. Such a dangerous complication of an attack, such as a retraction of the tongue, leading to asphyxia and death, occurs only in the case of the position of the head face up with the head tilted back.In no case do not allow such a position of the head!

5. It is necessary to wait until the seizure is over, being close to the patient and carefully observing his condition in order to correctly and fully describe the manifestations of the seizure to the doctor.

It is very important to note the time when the attack began, since the duration of an attack or a series of attacks, approaching 30 minutes, means that the patient enters a life-threatening condition – status epilepticus – a dangerous condition requiring urgent hospitalization and intensive care.

After an attack, the patient falls asleep. In this case, you do not need to disturb him in order to give an opportunity to recover the nerve cells exhausted from the attack. It is necessary to stay close to the patient and wait until the post-attack period ends and consciousness is fully restored.

6. During an attack, you should not try to restrain and restrict the convulsive movements of the patient, using force. Also, you can not unclench the jaws clenched by a spasm with your own hands or with a hard object. You can not water the patient with water, do artificial respiration.It is also not recommended to try to wake up the patient after an attack by shaking him, tapping him, letting him smell pungent odors or using any other methods.

7. Most seizures end on their own and last for a short time (a few seconds or minutes). Convulsive seizures usually stop spontaneously after 1-3 minutes, and therefore usually the patient does not need the help of a doctor. However, if the duration of the attack exceeds 5 minutes, it is necessary to call a doctor, intramuscular or intravenous administration of the drug is required to stop the attack.

Safety rules for patients with epilepsy.

People with epilepsy should try to lead a normal life, avoiding undue unjustified restrictions. However, it is necessary to observe a number of safety measures, especially while maintaining seizures with loss of consciousness.

The patient should not be without insurance at a height, at the edge of the platform of railway stations, near a fire and near water bodies!

Household safety rules.

1. All sources of ignition must be adequately covered and heating appliances must be removed to a safe place.

2. If a child sometimes has sudden (without aura) convulsive seizures, you can put plastic rounded plates on the corners of the furniture.

3. Whenever possible, doors, especially of the bathroom and toilet, should open outward so that a fallen child does not block the door. Also, latches and locks from the inside are undesirable.

4. A child should take a bath at a shallow water level and always in the presence of an adult.The water should not be very hot. The shower must be fixed high and secure.

5. Sometimes the patient is advised to wear special protective equipment, helmets.

Provoking factors for the onset of seizures.

Seizures usually occur without antecedents (spontaneous, random) and are completely unpredictable. However, in some patients, seizures are triggered by certain situations (for example, flickering light, restriction of sleep, stressful situations, strong feelings of fear or anger, taking certain medications or alcohol, hyperventilation).If the factors that provoke the onset of seizures are identified, they should be avoided, this will lead to a decrease in the frequency of seizures.

Advice on lifestyle for patients with epilepsy.

1.Sleep. A patient with epilepsy needs to sleep a sufficient number of hours a day, to avoid disturbances in the rhythm of sleep, early or abrupt awakenings. It is necessary to choose a mode of operation that meets this requirement, since in many patients, sleep restriction provokes the onset of seizures.It is necessary to avoid physical and mental overload, correctly alternate work and rest.

2.Power supply.

Must be complete and contain sufficient vitamins and minerals. A special “ketogenic diet” has been developed as a method of treating resistant and severe forms of epilepsy, but it is used only according to indications, under the supervision of a doctor in specialized medical centers.

3. Alcohol.

Increases the frequency and severity of seizures, as well as intensifies the side effects of antiepileptic drugs, therefore, a complete cessation of alcohol consumption is necessary!

4.Sport .

Professional sports are excluded for patients with epilepsy. However, patients with epilepsy can and should go in for sports (physiotherapy exercises), observing certain rules and restrictions (especially when seizures persist). Prohibited are sports related to climbing (mountaineering), speed sports, contact martial arts (for example, boxing), water sports. Cycling, rollerblading, seiteboarding or skating is possible with full control of seizures or with an aura and only with protective devices such as helmet and knee pads; at the same time, it is necessary to avoid busy streets and squares, roads with heavy traffic.Sports activities associated with climbing to a great height and the danger of falling, as well as dangerous sports equipment while seizures persist should be excluded. In patients with seizures provoked by hyperventilation, it is dangerous to engage in those sports in which hyperventilation is expressed (i.e. deep and rapid breathing).

A child should only bathe with adults who can provide immediate assistance with the initial manifestations of an attack (loss of coordination, focus, or slowing down of movement).Swimming is possible only in cases of persistent drug control of seizures, in the presence of an instructor who knows about the disease and is able to provide assistance.

Yoga, qigong and tai chi – oriental systems, including physical and psychological exercises, as well as controlling the depth of breathing, can be useful for patients with epilepsy.

Rules to be followed by an epileptic patient when watching TV:

1. A child should not watch TV for more than 1-1.5 hours

2.The distance to the TV should be as far as the room allows (at least 2 meters)

3. Mandatory additional lighting of the room to reduce light contrast

4. The TV set must be color with a smoothly adjusted contrast and a high scanning frequency (100Hz)

5.To control the TV, you need to use the remote control

6.To reduce the effect of flickering when viewing flickering pictures, flashes need to close one eye.

7.You should not watch TV if the patient does not get enough sleep, is tired or does not feel well enough

Rules to be followed by an epileptic patient while working or playing on a computer:

1. The duration of work / play on the computer should not exceed 1-1.5 hours with a mandatory break every 30 minutes for 10-15 minutes, which are necessary to rest the eyes

2. The distance from the eyes to the monitor must be at least 35 cm for 14-inch screens

3.Additional room lighting is mandatory to reduce light contrast

4. The monitor should not be exposed to glare from windows and other light sources

5. The monitor is preferably liquid crystal

6. It is impossible to view fine details of the image at close range.

7. It is necessary to remove other monitors and TVs from the field of view

8. Do not watch, work / play on the computer if the patient does not get enough sleep, is tired or does not feel well

It must be remembered that not only televisions and computers, but also natural phenomena (bright glare on the water, sparkling snow on a sunny day, alternating light and shadow, for example, when looking from the window of a moving train at the flickering of tree trunks on sunset) – such phenomena are often found in nature, they can also provoke in patients with photosensitivity.

For intensive light stimulation, it is recommended to close one eye.

Wearing sunglasses helps on sunny days.

Photos from open sources

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