A sudden breathlessness crisis happens when difficulty breathing comes on quickly, severely, and does not go away. It can be very scary for you, your family, and those who care for you. Not everyone with a breathing problem has episodes of sudden breathlessness. But people with advanced disease of the lungs, heart, or nervous system and those near the end of their life are more likely to experience a sudden breathlessness crisis.
Breathlessness may get worse in the following situations: developing pneumonia; a exacerbation of chronic lung or heart disease; environmental factors such as air pollution, exposure to wood smoke, fragrance, high humidity, wind, or cold/hot weather; travelling to high altitudes; fear, anxiety, panic. The mind-body connection is very strong, and emotions such as a feeling of being out of control or fear of dying, all can trigger an acute breathlessness crisis.
Here is a sample plan – the COMFORT – that you and your family/caregivers can modify and practice so that you are ready when you experience a sudden breathlessness crisis.
C: Call for help. Set up emergency contacts on your mobile or home phone. Have a baby monitor with video and two-way talk or a hand bell to let family or caregivers in the home know you need help. Develop a hand signal for your family or caregiver to indicate that “I need help!”
O: Observe for signs of breathing distress such as fast breathing, seeing neck muscles tighten, the stomach moving in with force during breathing, pounding sensation in the chest, or a fearful look on the face.
M: Medications Know which medications are used for breathlessness crisis and have them ready for use. These may be an inhaler, nebulizer, morphine, and/or medicine for anxiety.
F: Fan to face. Also, try opening the window or cooling the room. If driving in a car, open the window or turn on the air conditioner for air to circulate across the face.
O: Oxygen. Use oxygen if it has been prescribed. Other options to consider: clear secretions (sputum) if needed by using cough techniques, a mucus clearance device or high frequency chest wall therapy.
R: Reassure and relax. Slow down! Do things that make the surroundings calm. Examples are looking outside, guided imagery, prayer, or saying a mantra (repeating a meaningful word that brings peace). Ask someone to give you a light hand or back massage or use acupressure if you’ve been trained. Breathing strategies in addition to pursed lip breathing include counting inhalations/ exhalations, focus on movement of lower ribs, and gentle spinal movement with each breath. Using mindfulness or gentle exercises like restorative yoga or tai chi may be beneficial.
T: Take your time, don’t rush. Many times, people do not want to talk when having severe breathlessness.
Practice the plan with your whole family so everyone knows what to expect.
Even the youngest child can help by bringing an inhaler. You may need to change the plan when you find that something does not work.
Remember, breathlessness is uncomfortable and frightening but not necessarily harmful.
Article submitted by the HPA Health Group
