- Sx: Hyperventilation leading to peri-oral numbness and/or bilateral hand numbness, dizziness/lightheadedness, sense of dread/doom, tachypnea, tachycardia, elevated BP, palpitations, SOB, chest pressure.
- Order: EKG, CBC, CMP, TSH, Troponin, Chest x-ray, UA.
- If chest pressure is present: EKG, Troponin, Aspirin 325mg PO X 1 dose, NG, +/- Morphine if chest pain does not resolve.
- Short term (ER evaluation): Ativan 0.5mg PO X 1 dose. Reassess. Reassurance.
- Long term:
- Initiate SSRI as antidepressant help mitigate anxiety as well.
- May consider starting Buspar.
- Can start Hydroxyzine (Vistaril) PRN anxiety as well.
- Patient may also benefit from referral to therapist/Psychiatrist.