Managing breathlessness in Covid-19

Categories: Care.

The Cicely Saunders Institute at King’s College London has published guidelines for managing breathlessness, adapted to the context of Covid-19. 

Breathlessness is one of the main presenting symptoms of coronavirus (COVID-19). Breathlessness can be a very frightening symptom, even in milder cases.

According to the researchers, breathlessness is a distressing, multidimensional sensation resulting from complex interactions between physiological, environmental, cultural and social factors, with a considerable emotional component.

In COVID-19, when breathlessness becomes severe it can indicate pneumonia or acute respiratory distress syndrome (ARDS) which needs urgent investigation and treatment. The researchers note that this should be prioritised as an emergency if indicated.

Key recommendations for health care workers supporting someone with breathlessness include: 

  1. Identify and treat underlying causes of breathlessness
  2. Consider non-pharmacological treatments, in particular breathing techniques and positioning during breathlessness episodes
  3. More non-pharmacological treatments when people are less severely affected include: encourage pacing, planning, having what is needed frequently close to hand and having mobility aids close by
  4. Relaxation techniques or a relaxation DVD can also help breathlessness 
  5. Cooling the face, especially around the nose, is also believed to help reduce the sensation of breathlessness. This can be done by mopping a cool flannel on the nose and upper cheeks. In Covid-19, it is not recommended to use a fan, as this risks spreading droplets from the infected person.

You can read the detailed guidelines here

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