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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