At some point during the resuscitation, an advanced provider such as a Paramedic or AEMT will place an advanced airway into the patient’s airway. This measure is useful in that it resolves the problem of gastric distention, but it creates another problem: hyperventilation.

• The increased respiratory cycles will drop a patient’s blood pressure like a stone.
• The increased respiratory cycles will cause barotrauma.

To be honest, barotrauma is not a concern that EMS providers will be able to appreciate. Tiny blood vessels and alveoli blowing up under all the pressure is not exactly problems that rescuers are likely to identify. The real problem is dropping the patient’s blood pressure. If the patient is being ventilated and accepting of simple and advanced airways without the benefit of sedation, the patient wasn’t exactly that healthy to begin with.

Solutions To Hyperventilation Of Ventilated Patients

At georgiaemsacademy, we understand how exciting resuscitations can be. It behooves oneself to have their head on their shoulders in these situations. For this reason we offer some solutions:

• Let The Bag Valve Mask Tell You When To Ventilate – This simple solution has baffled people for years, but in an emergency, works every time. Simply turn the oxygen LPM to 8 LPM and ventilate only when the reservoir bag inflates. When you do this, the ventilatory rate will be about 8 to 10 breaths a minute. This is an emergency ‘easy button’ that results in easy to follow instructions.
• Use End Tidal CO2 To Tell You When To Ventilate – Attach a capnometry probe to the bag valve mask, ET tube, or other advanced airway and an world of information becomes available. If the end tidal CO2 measures somewhere between 35 and 45 mm/Hg, your ventilations are fine. If the end tidal CO2 is higher than 45 mm/Hg, the medics need to breathe faster. If the end tidal CO2 is lower than 35 mm/Hg, they need to decrease the respiratory rate.