Should hyperventilating patients breathe into a bag?

I remember it used to be advised that when a person is hyperventilating that they breathe into a paper bag.  Yet according to new medical practice guidelines this is not only no longer recommended, it is considered malpractice to recommend it to a patient.

Dr. Jeff Clawson, in his article, "Stand By The Protocol:  Some advice should stay in the bag," The Journal of Emergency Dispatch ( Sept./ Oct., 2011, pag7), explains that if you have otherwise not assessed the patient, you have no idea why the patient is hyperventilating. 

Dr. Clawson opened up this topic to discussion, to which one responder explained hyperventilating can be a symptom of a variety of underlying problems, such as:

• Asthma attack 
• Pulmonary emboli
• Heart attack

The responder explained that breathing into a paper bag when you have an underlying pulmonary problem can cause hypoxia and can make the patient's condition worse, and even cause death. 

The concept behind breathing into a paper bag is the belief that if a person is hyperventilating he is blowing off too much carbon dioxide (CO2).  If a person is breathing into a bag he will be rebreathing CO2 and thus bringing his CO2 level back to normal.  It's believed this might help stop the hyperventilating.

Another responder noted the following fact:  "I would also add that true hyperventilation, left untreated in the pre-arrival environment, is benign." 

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