R06.0 + (Z51.5)
DESCRIPTION
Dyspnoea is the subjective, unpleasant sensation of being unable to breathe adequately (breathlessness). Dyspnoea is a complex symptom which can be caused or exacerbated by physical, psychological, and emotional factors. The intensity of dyspnoea is not related to the oxygen saturation.
The aim should always be to address the cause, however, in end stage disease symptomatic treatment is indicated.
In children dyspnoea is often evidenced by difficulty talking or feeding, or restlessness.
GENERAL MEASURES
If available refer to a physiotherapist and occupational therapist for pulmonary rehabilitation, and to teach patients pursed lip breathing, pacing of activities, relaxation techniques and positioning.
A fan might reduce the sensation of dyspnoea.
Where possible treat the underlying cause e.g. antibiotics for underlying respiratory infection.
MEDICINE TREATMENT
Adults
- Morphine solution, oral. (Doctor prescribed)
- Starting dose: 2.5–5 mg as required, titrating up slowly.
Children
- Morphine solution, oral. (Doctor prescribed)
- Starting dose:
- 0–1 month of age: 0.05 mg/kg 6 hourly.
- ≥ 1–12 months of age: 0.1 mg/kg/dose 4 hourly.
- ≥ 12 months of age: 0.2–0.4 mg/kg/dose 4 hourly.
- Starting dose:
REFERRAL
Dyspnoea associated with hypoxia for consideration of home-based oxygen.