Relaxation positions for the breathless patient
If patients can be taught how to control their breathing during an attack of dyspnoea, this can be of great benefit to them. The patient should be put into a relaxed position, and encouraged to do ‘diaphragmatic’ breathing at his own rate. The rate of breathing does not matter at this stage; it is the pattern of breathing that is important. As the patient gains control of his breathing he should be encouraged to slow down his respiratory rate. Any of the following positions will assist relaxation of the upper chest while encouraging controlled diaphragmatic breathing. They can be adapted to various situations in everyday life.
HIGH SIDE LYING
Five or six pillows are used to raise the patient’s shoulders while lying on his side. One pillow should be placed between the waist and axilla, to keep the spine straight and prevent slipping down the bed. The top pillow must be above the shoulders, so that only the head and neck are supported. The underneath forearm can be placed under the head pillow, or resting on the bed underneath the pillow in the waist. It is more comfortable if the knees are bent and the top legplaced in front of the one beneath. This position is helpful for patients in, acute respiratory distress or those who suffer from acute breathlessness during the night.
FORWARD LEAN SITTING (Fig. 14/5 B, C)
The patient sits at the table leaning forward from the hips with the head and upper chest supported on several pillows. The back must be kept straight, so that diaphragmatic movement is not inhibited. Children can sit or kneel with the head and upper chest resting against pillows.
RELAXED SITTING
This is an unobtrusive position that can be taken up easily. The back should be kept straight, with the forearms resting on the thighs and the wrists relaxed.
FORWARD LEAN STANDING
If there is nowhere to sit many breathless patients find this position beneficial. The patient should lean forward with the forearms resting on an object of suitable height, such as the windowsill or banisters.
RELAXED STANDING
The patient can lean back against a wall with the feet placed slightly apart and approximately 30cm away from it. The shoulders and arms should be relaxed.
THOSE ABOVE ARE COLLECTED FROM SOME BOOKS AND
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