This week we discuss the workup and management of hiccups in the ED
Core EM - Emergency Medicine Podcast Episode 68.0 – Hiccups
Oct 17, 2016
This podcast dives into the unusual yet fascinating topic of hiccups, discussing their medical classification and a remarkable case of a patient with 70 years of hiccups. It explores the physiology behind hiccups, including the involved nerves and potential underlying conditions. The hosts share effective physical maneuvers and medication options for treatment, highlighting the importance of patient history in managing prolonged hiccups. It’s a mix of essential medical insight and entertaining anecdotes that bring this quirky phenomenon to life.
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Understanding Hiccups Reflex Arc
- Hiccups result from a reflex arc involving the vagus nerve, CNS, and phrenic nerve.
- Irritation anywhere along this arc causes the diaphragm to contract against a closed glottis, creating hiccups.
Hiccups Causes Overview
- Causes of prolonged hiccups can be from CNS or peripheral nerve irritation.
- CNS causes include stroke or tumors, while peripheral causes include GI, thoracic, ENT, metabolic, or medication-related issues.
First-Line Physical Maneuvers
- Try physical maneuvers first to stop hiccups by interrupting respiration or stimulating the vagus nerve.
- Techniques include breath-holding, Valsalva, sipping cold water, swallowing sugar, or pressing on eyeballs.