Having experienced panic attacks from a personal perspective as well as treating patients who have had them, I know how they feel and what is needed. First Aid Classes include what to and how to assist the patient.
St Mark James First Aid manual defines a panic attack as a period of extreme anxiety which has a sudden onset. They can occur for no clear reason, even in non-stressful circumstances.
Mental illnesses still have a negative stigma, and panic attacks can sometimes be viewed as attention-seeking, but as a person who has been through them, I can testify that they are uncontrollable and very distressing for the patient.
Note – slapping or shaking them, retraining them, or shouting at them to pull it together doesn’t help! Just don’t do it!
Symptoms of a panic attack include hyperventilation (over-breathing), fast pulse rate and possibly palpitations, trembling, sweating, dry mouth, muscular tension, sometimes resulting in headache, backache or a feeling of pressure in the chest, and extreme apprehension and fear of dying.
Personally, my anxiety attacks didn’t give me a fear of dying or pain or pressure, however they did give me palpitations, hyperventilation, sweating, hand tremors, and muscular tension, particularly in my legs causing them to shake uncontrollably. I also experienced diarrhoea and vomiting from my panic attacks.
There is not always a clear cause for panic attacks, I often had no reason to have a panic attack, however the fear alone of having one can cause the patient to panic. This starts a vicious circle.
So what can you do as a First Aider?
Your job is to remove any obvious cause of panic, and to assist the patient regain control. St Mark James Training suggests taking the patient to a quiet area, where they have space and time to calm down. Explain to the patient that they are having a panic attack if they’re not already aware. It is not always obvious to the patient what is happening, certainly for my first few panic attacks I didn’t understand why it was happening or what it was.
Encourage and assist the patient to control their breathing and slow their respiratory rate down. If the patient is hyperventilating, try to get them to breathe into a paper bag to help control their symptoms as shown in First Aid Classes. Another trick I learnt through my own experience was to use cupped hands if you don’t have a paper bag available.
The idea is to re-breathe the carbon dioxide that you are breathing out. When you hyperventilate, the faster breathing takes in extra oxygen and expels more carbon dioxide, which disrupts the body’s pH levels
. By breathing in a paper bag or cupped hands you take some of the carbon dioxide back in and restore pH balance, thereby reducing the symptoms.
I personally always found distractions very helpful; try to get the patient thinking about something other than the cause of the panic or the panic attack itself. I liked to find something to keep my brain busy such as counting something in your surroundings eg. trees or cars.
Continue to reassure them and speak in a calm voice, and as per the St Mark James First Aid manual, stay with the patient until they have recovered.