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Sacamuelas · 08-03-2004, 07:24

I can be caused by a lot of different reasons- low CO2 levels being only one of them.
Here are a few treatments used:

Stimulation of nasopharynx - Forcible traction on the tongue, swallowing granulated sugar, gargling with water, sipping ice water, drinking from the far side of a glass, biting on a lemon, inhaling noxious agents (eg, ammonia)
C3-5 dermatome stimulation - Tapping or rubbing back of the neck, coolant sprays, acupuncture
Direct pharyngeal stimulation - Nasal or oral catheter (90% effective)
Direct uvular stimulation - Spoon or cotton-tip applicator
Removal of gastric contents - Emetics, nasogastric tube
Vagal stimulation (Only one technique at a time is recommended.)
1. Iced gastric lavage
2.Valsalva
3.Carotid sinus massage
4.Digital ocular globe pressure
5.Digital rectal massage
Interference with normal respiratory function - Breath holding, hyperventilation, gasping (ie, fright), breathing into a paper bag (increases partial pressure of carbon dioxide), pulling knees up to chest and leaning forward, continuous positive airway pressure, rebreathing 5% carbon dioxide
Mental distraction - For example, ask the patient to "think of a loved one remembering you." Offer $10 if the patient can continue to hiccup immediately.
Behavioral conditioning (including other members of the family unit)
Hypnosis
Acupuncture
Phrenic nerve or diaphragmatic pacing: Incidental cure during cardioversion has been reported.
Phrenic nerve block surgery: Surgical interruption of the phrenic nerve has been advocated for intractable cases that are unresponsive to other treatment. This final and most drastic approach may be associated with considerable morbidity and is not universally successful. Microvascular decompression of the vagus nerve recently has been described as a successful procedure

Obviously, some of these are for higher level care due to protracted cases that last for a long time. For the "standard" brief cases...The mental distraction, rebreathing Co2 from paper bag, and holding breath seem to always work for me.

08-03-2004, 07:24	#12
Sacamuelas JAWBREAKER Join Date: Jan 2004 Location: Gulf coast Posts: 1,906	I can be caused by a lot of different reasons- low CO2 levels being only one of them. Here are a few treatments used: Stimulation of nasopharynx - Forcible traction on the tongue, swallowing granulated sugar, gargling with water, sipping ice water, drinking from the far side of a glass, biting on a lemon, inhaling noxious agents (eg, ammonia) C3-5 dermatome stimulation - Tapping or rubbing back of the neck, coolant sprays, acupuncture Direct pharyngeal stimulation - Nasal or oral catheter (90% effective) Direct uvular stimulation - Spoon or cotton-tip applicator Removal of gastric contents - Emetics, nasogastric tube Vagal stimulation (Only one technique at a time is recommended.) 1. Iced gastric lavage 2.Valsalva 3.Carotid sinus massage 4.Digital ocular globe pressure 5.Digital rectal massage Interference with normal respiratory function - Breath holding, hyperventilation, gasping (ie, fright), breathing into a paper bag (increases partial pressure of carbon dioxide), pulling knees up to chest and leaning forward, continuous positive airway pressure, rebreathing 5% carbon dioxide Mental distraction - For example, ask the patient to "think of a loved one remembering you." Offer $10 if the patient can continue to hiccup immediately. Behavioral conditioning (including other members of the family unit) Hypnosis Acupuncture Phrenic nerve or diaphragmatic pacing: Incidental cure during cardioversion has been reported. Phrenic nerve block surgery: Surgical interruption of the phrenic nerve has been advocated for intractable cases that are unresponsive to other treatment. This final and most drastic approach may be associated with considerable morbidity and is not universally successful. Microvascular decompression of the vagus nerve recently has been described as a successful procedure Obviously, some of these are for higher level care due to protracted cases that last for a long time. For the "standard" brief cases...The mental distraction, rebreathing Co2 from paper bag, and holding breath seem to always work for me.
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