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I posted this on the EM forum, but it only got like 18 views in a week or so-- sorry for the double post.

I have a question about respiratory alkalosis due to Hyperventilation for Step II. Both Kaplan and USMLE World have re-breathing into a paper bag as the first line treatment; followed by sedatives such as short acting benzo's.

Tintinalli, Emedicine, WebMD, MedlinePlus all say that paper bag breathing is no longer reccomended (some even underline and/or put that in all caps) due to the potential for hypoxia that can even lead to death. They all reccommend encouraging the patient to breath slower and then benzo's as a 2nd line Tx.

What's the dealio for USMLE step II?










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