1. Rachel Williams Clinical Specialist Respiratory Physiotherapist
Breathlessness
Rachel Williams
Clinical Specialist Respiratory Physiotherapist

2. Definition
Uncomfortable awareness of one’s breathing, a subjective experience of breathing discomfort, air hunger
subjective
individual
Practical exercise with straws- how does it feel?

4. Assessment
It is important to ask what is causing the breathlessness at this time and is it reversible?
is it disease process?- slowly increasing year on year in the case of COPD, variable from day to day with asthma
is it sputum?
is it anxiety and panic?
is it a dysfunctional breathing pattern?
is it issues with pacing and energy conservation?
is it deconditioning?
any other causes?
or is it refractory- no reversible causes

5. Treatment breathing control techniques/sputum clearance
pursed lipped breathing
positioning
pulmonary rehabilitation
breathing retraining- dysfunctional breathers/vocal cord dysfunction
anxiety management
mindfulness and relaxation
energy conservation and activity pacing
ACBT, breathing control techniques, pursed lipped breathing, positions of rest

6. Treatment
fan therapy- stimulation of the second and third branches of the trigeminal nerve
pharmacological management- opioids, benzodiazepines??
palliative oxygen therapy - BTS oxygen guidelines 2015
Patients with cancer or end stage cardiorespiratory disease who are experiencing intractable breathlessness should NOT receive treatment with POT if they are non-hypoxaemic or have mild levels of hypoxaemia.
Patients should receive assessment for a trial of treatment of opiods