Managing hyperventilation syndrome in dental practice

Hyperventilation syndrome can occur when a patient hyperventilates (overbreathes). It is common, and is often associated with anxiety or panic attacks. For signs and symptoms of hyperventilation syndrome, see Signs and symptoms of hyperventilation syndrome; signs and symptoms may be similar to syncope, asthma attack, anaphylaxis or a myocardial infarction.

Table 1. Signs and symptoms of hyperventilation syndrome
Symptoms	Signs
light-headedness dizziness shortness of breath feeling of panic and impending death blurred vision tingling in the fingers, toes and lips feeling of detachment	rapid breathing occasional deep sighing breaths rapid heart rate altered consciousness involuntary contraction of the hands and fingers

Observe patients after the administration of a local anaesthetic, because hyperventilation syndrome commonly occurs at that time.

In dental practice, follow the advice in Management of hyperventilation syndrome in dental practice for first-aid management of patients with hyperventilation syndrome.

Figure 1. Management of hyperventilation syndrome in dental practice

If hyperventilation syndrome occurs:

Stop dental treatment.
Encourage the patient to slow their breathing, and to breathe in through their nose and out through their mouth.
Reassure the patient, explain the cause of the symptoms, and have them talk to you.
Re-breathing into a bag is not recommended.

If the patient does not rapidly recover, review the diagnosis.

If acute symptoms persist for more than 5 to 10 minutes: