Dyspnoea

Question 1

Definition

Answer 1

subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity

• types of sensation and intensity varies form person to person
• can only be perceived by the person experiencing it

Question 2

Causes

Answer 2

As the demand for ventilation exceeds body’s capacity to meet these demands = imabalnce between motor drive to breathe and input from chemoreceptors and mechanoreceptors
Person feels as though they need to breathe more but are being told by their body that they are unable to do so = distress

Impaired gas exchange 
reduced lung volumes 
perfusion impairments 
CV disease 
haematological disease
reduced exercise tolerance 
respiratory or musculoskeletal dysfunction

Question 3

Clinical Significance

Answer 3

extremely distressing and disabling - vicious cycle of inactivity
avoidance behaviour
respiratory muscle dysfunction
musculoskeletal dysfunction

Question 4

Clinical Features

Answer 4

Subjective Reporting - MOST IMPORTANT 
Observe - accessory muscle use
- pursed lip breathing 
- paradoxical breathing pattern 
- increased work of breathing

Question 5

Physio Management

Answer 5

ACUTE - result of physiological derangement

• need to treat underlying issues
• medical management
• supplemental oxygen
• breathing control and positioning

CHRONIC

• more emphasis on self management
• behaviours and lifestyle modification
• address positions of breathlessness
• breathing exercises
• anything to alleviate anxiety/distress

Positions for breathlessness
Teach breathing control
Teach pursed lip breathing

Question 6

Physio Intervention - COPD Dyspnoea

Answer 6

fix the shoulder girld
forward learning sitting
positioning advise - sitting learning forward, sitting leaning on pillows, standing leaning back, standing leaning forward
breathing techniques - breathing control at rest, pursed lip breathing, exhalation on effort, relaxed, slow, deep breathing, paced breathing
manage anxiety and panic