Breathing Re-education

Question 1

Aims

Answer 1

> Reduce Work of Breathing
Give confidence to control breathless attacks
*only if it is causing them a problem - their breathing pattern may actually be best for them

Acute patients
> can treat signs/symptoms
> reverse problem

Question 2

Breathing Control

Answer 2

> Normal tidal breathing encouraging relaxation of upper chest + shoulders

Question 3

Diaphragmatic breathing

Answer 3

> Breathing using abdominal movement (reduce chest wall movement as much as possible)
> Theory:
- Decrease airway turbulence
- decrease dead space 
- favour dependent regions
- relax shoulder girdle 

> Method: Relaxed tone

• In through nose (filters, moistens and heats air)
• Out through mouth (sighing)
• hand on abdomen - ‘fill the balloon’
• replace your hand with patients to educate them on how it feels

Question 4

Deep Breathing (Thoracic expansion exercises)

Answer 4

> Theory

• Increase lung volume
• Increase ventilation
• Decrease airway resistance
• increase surfactant secretion
• Aid V/q matching
• decrease dead space
• increase diffusion
• increase O2 saturation

> Method: Motivational
- Breath in deeply through nose
- Breath out of mouth (long + slow) - feel bucket handle
+ sniff to get extra air in
+ hold for 3 seconds - opens more alveoli

*Don’t do too many patient may get light-headed if we overdo it