Reflection on practice: an intubated patient suffering panic attacks.
Panic attacks and respiratory disease have been shown to have probable links; which one is the precursor to the other is unknown. However, what is known is that there is a correlation between high serum carbon dioxide and lactate levels, which are suffocation indicators, and panic attacks. Females are at a higher risk of suffering panic attacks than men, as they have been shown to have a lower tolerance of suffocation indicators. The aim of this paper is to review the relevance of panic attacks within the intensive care unit setting, where a significant number of patients with respiratory disease have an oral endotracheal tube, which limits communication and may add to the feeling of panic. Using a reflective model, I revisited the actual scenario and consider the series of events as I reflect in action, and at the conclusion of the situation, I reflect on action. The results show that suffering from panic attacks did not inhibit the patient with weaning from the ventilator. Effective communication between the patient and myself led to recognition of the problem, for the correct treatment to be being given, and enabling subsequent extubation. In conclusion, once the link is made of the likelihood of a patient with respiratory disease being prone to panic attacks, the nurse can communicate with the patient or family to establish whether the patient has a panic disorder. The treatment of a regular benzodiazepine, such as diazepam, and constant reassurance from the nurse can then be given to the patient to minimize the symptoms. Reducing the effects of panic attacks can decrease the distress experienced by the patient and improve the clinical picture to facilitate extubation.
Davies
Debbie
D
ICU, Hutt Hospital, Lower Hutt, New Zealand. markndeb@xtra.co.nz
D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000451:nursing; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007442:Intubation, Intratracheal; D016584:Panic Disorder / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D012120:Respiration Disorders / Q000175:diagnosis / Q000451:nursing / Q000628:therapy*; D012121:Respiration, Artificial; D018570:Risk Assessment; D015300:Ventilator Weaning / Q000009:adverse effects* / Q000451:nursing