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Covid-19 Primary Care Resources

Managing breathlessness

Information for patients on post Covid breathlessness, GP guidelines from NICE and links to prescribing guidance for EOLC

This information is sourced from Homerton University Hospital NHS Foundation Trust and the Chartered Society of Physiotherapy(CSP):

The ACERs team at Homerton Hospital have produced a Post Covid-19 patient information pack which includes a section on positions and exercises to manage breathlessness

The CSP have produced a video for patients on managing breathlessness

This information is sourced from NICE:

Identify and treat reversible causes of breathlessness, for example, pulmonary oedema, pulmonary embolism, chronic obstructive pulmonary disorder and asthma

Severe breathlessness often causes anxiety, which can then increase breathlessness further

When significant medical pathology has been excluded or further investigation is inappropriate, the following may help to manage breathlessness as part of supportive care:

  • keeping the room cool
  • encouraging relaxation and breathing techniques, and changing body positioning
  • encouraging people who are self-isolating alone to improve air circulation by opening a window or door

If hypoxia is the likely cause of breathlessness:

  • consider a trial of oxygen therapy
  • discuss with the person, their family or carer possible transfer to and evaluation in secondary care

Consider an opioid and benzodiazepine combination. There is a table from NICE to aid prescribing for managing breathlessness in the last days and hours of life for people 18 years and over with Covid-19 who:

  • are at the end of life and
  • have moderate to severe breathlessness and
  • are distressed

Consider concomitant use of an antiemetic and a regular stimulant laxative. Seek specialist advice for children and young people under 18 years.


Published: 05/01/2021
Published: 24/06/2020