Panic Attack

Panic Attack:

  • 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)┬áPRN anxiety as well.
    • Patient may also benefit from referral to therapist/Psychiatrist.

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