Carbon Dioxide for Hiccoughs

Abstract

IT is only within the past few years that the value of carbon dioxid gas as an aid in stimulating respirations has been understood. Today, it is the most valuable agent we have. Under normal conditions the blood contains little more than 5 per cent carbon dioxid, which is kept at an even balance by the rate of respirations. If this amount is increased to, say, 10 per cent, the respiratory center is further stimulated and breathing is increased, so that an individual is forced to breathe even against his will. It becomes obvious, then, why carbon dioxid is being so generally used in the administration of anesthetics and as a valuable aid in relieving hiccoughs. Hiccough is a spasmodic contraction of the diaphragm, the most important muscle of respiration, probably caused by some irritation. It is possible to force breathing with carbon dioxid until this irritation has worn off and hiccough stops. Carbon dioxid may be obtained in cylinders, mixed with oxygen, in any per cent specified. It must be kept in mind that 5 per cent carbon dioxid and 95 per cent oxygen produce normal breathing, and a concentration greater than 10 per cent carbon dioxid probably should not be used. A simple method for administration of carbon dioxid on the wards consists of an ordinary closed anesthetic mask with a gas bag attached to the gas cylinder. The bag is filled and shut off, the patient is allowed to breathe back and forth in the bag for about one minute, then the bag is emptied, refilled, and the process is continued. During the administration, if the patient's breathing becomes deep and labored (sign of over-dosage) the mask is removed to allow excess carbon dioxid to be exhaled. Breathing will then become normal. The mask is reapplied and the treatment continued in this way until hiccough stops. Relief may be of short duration, or it may last for several hours. The treatment may be resumed as often as is necessary and, after sufficient instruction, it may be carried on by the general nursing staff.