The Elizabeth Hospice Palliative Reference Cards

DYSPNEA ASSESSMENT

Medical Research Council ( MRC ) Dyspnea Scale for COPD

Respiratory Depression Uncommon Increased risk if patient has • Obesity • Sleep apnea

0 = Strenuous exercise 1 = Walking fast on level ground, or walking uphill 2 = Walking slower than others on level ground, or stop for breath walking own pace on level ground 3 = Stop for breath after 100 yds / few minutes on level ground 4 = Too breathless to leave house or dress

NON-VERBAL ASSESSMENT

Modified Borg Dyspnea Scale Self-rating of shortness of breath 0 = Nothing at all 1 = Very slight 2 = Slight 3 = Moderate 4 = Somewhat severe 5 = Severe 6 7 = Very severe 8 9 = Very very severe 10 = Maximal

Variable

0 points

1 point

2 points

Total

Heart rate / minute < 90 beats

90‒109 beats

≥ 110 beats > 30 breaths

Respiratory rate / minute Restlessness: non-purposeful movements Paradoxical breathing pattern: abdomen moves in on inspiration Accessory muscle use: rise in clavicle during inspiration Grunting at end-expiration: guttural sound Nasal flaring: involuntary movement of nares

≤ 18 breaths 19‒30 breaths

Occasional slight movements

None

Frequent movements

None

Present

None

Slight rise

Pronounced rise

None

Present

None

Present

Eyes wide open, facial muscles tense, brow furrowed, mouth open, teeth together Total:

Look of fear

None

X / 16

22 NB: These Reference Cards do not replace careful clinical judgment specific to each patient / family situation. PCIC: Palliative Care Interdisciplinary Curriculum is a collaborative effort of OhioHealth, The Ohio State University Wexner Medical Center, and Nationwide Children’s Hospital in Columbus, Ohio, USA, and other contributors. Permission to reproduce any or all of these PCIC Reference Cards is granted for non-commercial educational purposes only, provided that the attribution statement and copyright are displayed. To reproduce for all other purposes, contact Frank D. Ferris at info@pallmed.us. Copyright © Frank D Ferris 2013-2024. All rights reserved. V14.1, 2024

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