Breathlessness

Clinical Description

Common causes (see relevant chapter for details)

Signs and Symptoms

• TB, pleural effusion, pneumonia, heart failure, pulmonary embolism, COVID, severe pain/ascites

Non-pharmacological

• Sit upright in comfortable position, sit near open window to ensure good ventilation, fanning face can help to reduce experience of breathlessness, relieve anxiety therapeutic drainage of effusion (risk of infection if recurrent drainage).

Pharmacological

• Immediate release oral morphine 2.5mg 4 hourly can reduce the experience of breathlessness higher doses may be used if patient is also in pain, monitor response, stop if not helping.

Complications and Referral Criteria

• Think carefully before referring a patient for oxygen therapy. If the cause is irreversible, will it really benefit the patient?