Breathing deeply can kill people.

Last Saturday night, I worked as an emergency doctor on the flight back to Beijing. At that time, I covered the nose and mouth of a "suffocating" person with a cleaning bag on the plane, which saved her quickly. The people on the plane didn’t understand my actions very much, and even questioned me, "Let people who lack oxygen be more deprived of oxygen". What is the reason?

Emergency situation

Here’s what happened.

The patient is a young mother with a child over one and a half years old. When the plane is about to land, she suddenly has dizziness and nausea. At first I thought it was common airsickness, however, I soon found that the situation was not so simple. The young mother’s breathing became heavier and heavier, and sweat dripped from her pale face. She said that her hand was cramping and she could hardly hold the baby.

When I heard that my hand was going to cramp, my head buzzed: this is almost a replica of the thrilling scene that happened in our ward a few months ago. Therefore, I have a preliminary diagnosis.

I asked the flight attendants to find a plastic bag, but they seemed to understand my intention, but they couldn’t find it at the moment. In a hurry, I asked the flight attendant to tear open a cleaning bag and prepare to buckle it on the young mother’s face.

I have my reasons, but the young mother violently resisted. She cried painfully, "Take it away, I’m choking! I don’t want it! "

People around me looked at me with suspicion and even horror. I quickly said loudly: "I am a doctor! I will explain it to you later! "

After I exposed myself as a doctor, everyone withdrew some suspicious eyes, but the young mother still refused to let me cover my nose with a paper bag. I had to hold a paper bag, keep a short distance from her nose and mouth, and at the same time let her relax and not take deep breaths. It would be better if I could hold it for a while. I told her in an unquestionable tone: "Don’t worry! You can’t hold back! "

In order to reduce the young mother’s fear, I put the paper bag a little farther away from her mouth, so that she didn’t feel her mouth and nose covered. Although the bag is a little far away, the gas she exhaled will still be blocked by the bag and then inhaled by her again. This is correct in theory and necessary in practice.

At this time, someone asked me which hospital I was a doctor, and I blurted out, "I’m from Union Medical College Hospital!" " I didn’t hide it, mainly because I wanted to use the reputation of the "owner" to make patients more relaxed and reassure everyone, that’s all.

A few minutes later, the young mother said that she felt better, and her convulsive hands relaxed a lot. After the situation eased a little, people around me asked me why I had to cover her nose and mouth with a paper bag. Isn’t she more deprived of oxygen and more uncomfortable?

So, I told you what the doctor on duty in our hospital a few months ago said.

I’ll help.

This is a special dangerous situation called hyperventilation syndrome.

Young mothers with children may be too nervous, feel a little uncomfortable when the plane descends, and worry that their children will be left unattended, so they become more nervous, take a big breath and exhale a lot of carbon dioxide, which leads to the decrease of carbon dioxide concentration in the body, and a dangerous pathological situation-respiratory alkalosis appears.

The internal environment of human body needs to maintain acid-base balance, and carbon dioxide combines with water in the body to form carbonic acid. If there is lack of oxygen and too much carbon dioxide, acidosis will occur, such as patients with respiratory diseases or terminal stage. On the contrary, if there is too little carbon dioxide in the body, there will be insufficient carbonic acid, which will lead to alkalosis.

When respiratory alkalosis occurs, the combination of calcium ion and albumin in the blood increases, so that the concentration of free calcium ion decreases, and people will have increased nerve and muscle stress, feel numbness around the mouth and limbs, muscle spasm, tinnitus, etc., and tetany may occur, and even seizures may occur. If not handled in time, it will soon be life-threatening.

The young mother breathed heavily because of nervousness, and discharged the carbon dioxide from her body, resulting in a lack of carbon dioxide. So I will cover her mouth with a bag to let her breathe the carbon dioxide she exhaled back into her lungs, so as to improve the carbon dioxide concentration in her blood. After correcting the alkalosis, her hand and foot convulsions naturally eased.

Happy Ending

Before getting off the plane, the flight attendant gave me a small gift, thanking me for my help to the passengers on the plane and imparting medical knowledge. She said that although she had been trained about hyperventilation in the cabin emergency retraining, she didn’t know the medical reason. Moreover, with doctors present, doctors speak much more effectively than their flight attendants.

I have always believed that although evidence-based medicine is advocated now, medicine is still an empirical science to some extent. Some things, some diseases, only when you have seen and heard them, can you think of them, deal with them and dare to deal with them.

This is the fourth time that I have participated in the "rescue" of passengers, but it is the only time that I have actually used my professional knowledge to save the lives of passengers who feel "dying". This is also the main reason why I share this story.