From the Guidelines
If you experience shortness of breath, it is crucial to remain calm and seek medical attention immediately if the symptoms are sudden, severe, or accompanied by other alarming signs. When experiencing shortness of breath, first try to sit upright in a comfortable position that allows your lungs to expand fully. For mild cases, slow, deep breathing through pursed lips can help regulate your breathing pattern.
Important Considerations
- If shortness of breath is sudden, severe, or accompanied by chest pain, blue lips, confusion, or fainting, call emergency services immediately as these may indicate a life-threatening condition.
- For those with known respiratory conditions like asthma or COPD, use your prescribed rescue medications such as albuterol (typically 2 puffs every 4-6 hours as needed) or other prescribed inhalers according to your treatment plan 1.
- Removing yourself from potential triggers like allergens, smoke, or pollutants may help ease symptoms.
- It is essential to note that oxygen therapy should be titrated to the patient’s oxygen saturation, especially in patients with acute exacerbations of COPD, as untitrated oxygen at a rate of 8 to 10 L/min can be harmful 1.
Seeking Medical Attention
If shortness of breath persists despite these measures, worsens over time, occurs at rest, or interferes with daily activities, seek medical attention promptly. Shortness of breath can result from various causes including respiratory conditions, heart problems, anxiety, or physical exertion, so proper diagnosis is essential for effective treatment. Given the potential for harm with untitrated oxygen, it is suggested to follow a good practice statement that includes considerations for patients with COPD, as outlined in the most recent consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations 1.
From the Research
Causes of Shortness of Breath (SOB)
- Shortness of breath, or dyspnoea, can be associated with significant pathology, making prompt identification and appropriate management imperative 2
- It may be caused by various factors, including coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), hypertension (HTN), and gastroesophageal reflux disorder (GERD) 3
- Other possible causes include pulmonary embolus (PE), foreign body obstruction, and healthcare-associated pneumonia (HCAP) 3
Evaluation and Management of SOB
- The management of an acutely short of breath (ASOB) patient should follow an algorithm incorporating simultaneous assessment and resuscitation 2
- A formal diagnosis guides risk stratification, prognostication, and treatment, but should not delay resuscitation 2
- Evaluation of the patient with shortness of breath can be challenging, and pitfalls in the evaluation should be avoided 4
- Treatment should be evidence-based and tailored to the patient's history and present needs, with corticosteroids, antibiotics, and bronchodilators being the cornerstones of prevention and therapy for acute exacerbations of COPD 5
Key Considerations
- Patient history may not always be indicative of the cause of shortness of breath 3
- A thorough work-up, including imaging studies such as CT scans, may be necessary to determine the etiology of shortness of breath 3
- Recommendations for further research on the evaluation and management of shortness of breath have been discussed in the literature 6