One should not ignore the fact that life-threatening situations can occur (e.g. acute hemorrhage, suffocation) that do require immediate medical attention.
Consistent with earlier suggestions that panic is a false biological alarm, the affective response to CO2 may be part of a protective system triggered by suffocation and acute metabolic distress.
Physical reasons mentioned in the interviews were the experience of acute or chronic pain, suffocation, chronic nausea, incontinence, smelling wounds, ulcerations, drowsiness, etc. Psychological reasons were anxiety, feelings of sadness, loss of perspective and hope, and the fear of being confused, unable to make decisions, becoming dependent on nursing care or being 'hooked up to machines'.
Years later, in my 30s, the shrill and the lights of ambulances would induce acute anxiety, a feeling of suffocation.
The idea that panic may proceed from a suffocation alarm disrupted by acute CO2 loading is perfectly consonant with such views.
Explained deaths were subdivided into those with or without acute hypoxic insult as the immediate cause, the former including drowning and intentional suffocation.
My own father died in my home by suffocation… unable to express himself… unconscious… The experience I had that day was too acute for time to erase… (Participant 5) The serious structural weakness, which is worsening as my disease progresses, is taking me from my armchair to my bed to drowse or to sleep… (Participant 5) My main anxiety is choking and suffocation.
The causes of mortality could not be determined whether they were procedure-related (suffocation, aspiration pneumonia, bowel trauma, incomplete endoscopic hemostasis, as extra), bleeding-related or other causes such as acute myocardial infarction, brain stroke, perforated peptic ulcer, as extra.
In light of the above mentioned cases, acute resection of the laryngocele or tracheotomy should be done as a "lege artis" action in patients at risk of suffocation, particularly in patients with a laryngocele having an extensive internal part.
