Remote assessment of breathlessness

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Goodfellow Gems

Remote assessment of breathlessness

Some guiding principles on remote COVID assessments by video link or telephone.1

1. Check whether the patient can complete their sentences with ease and comfort:

  •    How is your breathing today?

2. The (UK) NHS 111 symptom checker asks three questions:

  •  Are you so breathless that you are unable to speak more than a few words?
  • Are you breathing harder or faster than usual when doing nothing at all?”
  • Are you so ill that you've stopped doing all of your usual daily activities?

3. Focus on change-deterioration rather than current S.O.B.

  • Is your breathing faster, slower, or the same as normal?
  • What could you do yesterday that you can’t do today?
  • What makes you breathless now that didn’t make you breathless yesterday?

4. Interpret the breathlessness in the context of the wider history and physical signs e.g. a new, audible wheeze and a verbal report of blueness of the lips.

5. Respiratory rate not by phone but by good video connection.

Reference:

  1. Video consultations for covid-19 an opportunity in a crisis. BMJ (2020) View here

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.