Respiratory distress: A model of responses and behaviors to an asphyxial threat for patients who are unable to self-report

Campbell, Margaret L.

doi:10.1016/j.hrtlng.2007.05.007

Cited by 31 publications

(24 citation statements)

References 50 publications

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“…Because dyspnea is a symptom (i.e., perception of an abnormal or distressing internal state), it must generally be distinguished from signs that clinicians typically invoke as evidence of respiratory distress, such as tachypnea, use of accessory muscles, and intercostal retractions (19)(20)(21)(22)(23). Within the definition of dyspnea, we have avoided using terms such as "difficult," "labored," or "heavy" breathing because they may or may not characterize the experience of a particular patient at a given point in time.…”

Section: Definitionmentioning

confidence: 99%

See 1 more Smart Citation

An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

Parshall¹,

Schwartzstein²,

Adams³

et al. 2012

Am J Respir Crit Care Med

1,505

1,328

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Section: Definitionmentioning

confidence: 99%

“…or what patient population will be assessed better with the new instrument than with existing measures? Recent work on developing an observational respiratory distress rating for palliative care patients who are unable to self-report provides an example of such justification (19,20,23).…”

Section: Research Prioritiesmentioning

confidence: 99%

An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

Parshall¹,

Schwartzstein²,

Adams³

et al. 2012

Am J Respir Crit Care Med

1,505

1,328

View full text Add to dashboard Cite

“…Although dyspnea is a subjective experience, it is characterized by observable behaviors [43] . The inability of an individual to self-report dyspnea may result in a failure by nurses to identify this as a change in the patient status from a physiological perspective and appropriately treat this distressing symptom [44] .…”

Section: Dyspneamentioning

confidence: 99%

“…The inability of an individual to self-report dyspnea may result in a failure by nurses to identify this as a change in the patient status from a physiological perspective and appropriately treat this distressing symptom [44] . Campbell [43] suggests that stimulation of the autonomic nervous system produces observational and measurable behaviors. These involuntary responses are elicited sequentially and include: increased heart rate, tachypnea, restlessness, accessory muscle use, end expiratory grunting, involuntary nasal flaring and fearful facial expressions [45] .…”

Section: Dyspneamentioning

confidence: 99%

Best practice in nursing care of dyspnea: The 6th vital sign in individuals with COPD

Bailey

Boyles

Cloutier

et al. 2013

JNEP

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Aim: The aim of this paper is to highlight evidence and key nursing practice, education, organization and policy recommendations from the original and revised Registered Nurses' Association of Ontario Best Practice Guideline, Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease (COPD). This paper introduces the notion of dyspnea as the sixth vital sign and presents evidence from the RNAO Best Practice Guideline and other relevant literature to support and enhance nursing care of dyspnea in clients with COPD.Background: COPD is an increasingly serious health issue. Nurses have significant opportunity to positively influence client outcomes and quality of life by assessing dyspnea, identifying problems, and applying appropriate evidence-based interventions. Best practice guidelines developed by the RNAO provide a framework to enhance nursing practice and client care.Design: A panel of nurses was assembled for the initial development of the guideline and more recently, the revision to the original guideline.Method: A structured evidence review based on the scope of the original guideline and supported by three clinical questions was conducted to capture the relevant literature and guidelines published since the original publication.Results: As a result of this work recommendations for nursing practice and education are discussed. Organizational and policy recommendations are also outlined. Conclusions:Nurses have opportunity to positively influence client outcomes and quality of life by assessing dyspnea, identifying problems, and applying appropriate evidence-based interventions.Relevance to Clinical Practice: Recommendations made in the best practice guideline will enhance nursing care of dyspnea in clients with COPD and dyspnea should be recognized as the sixth vital sign in individuals with COPD.

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“…Areas in the brainstem and amygdala activate pulmonary stress behaviors and a fear response. 17 The postulated behaviors in the framework Oxygen can be withheld or withdrawn from patients who are actively dying and showing no signs of respiratory distress.…”

Section: Assessmentmentioning

confidence: 99%

Ensuring Breathing Comfort at the End of Life: The Integral Role of the Critical Care Nurse

Campbell

2018

American Journal of Critical Care

Self Cite

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This article describes the author’s program of clinical research focused on assessment and treatment of respiratory distress among critically ill patients at the end of life. Dyspnea is a subjective experience of breathing discomfort that occurs in the presence of cardiopulmonary and neuromuscular diseases. Dyspnea is one of the most common and most distressing symptoms experienced by critically ill patients. Many critically ill patients, particularly those not expected to survive, become cognitively impaired or unconscious and lose the ability to report symptoms, although dyspnea can be known only from a patient’s report. When self-reporting ability is lost, the critical care nurse must rely on signs indicative of a patient’s respiratory distress. The critically ill patient unable to self-report is vulnerable to under-recognition of symptom distress and subsequent over-treatment or undertreatment. When the patient is dying, there is only 1 chance to optimize the assessment and treatment of symptoms.

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Respiratory distress: A model of responses and behaviors to an asphyxial threat for patients who are unable to self-report

Cited by 31 publications

References 50 publications

An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

Best practice in nursing care of dyspnea: The 6th vital sign in individuals with COPD

Ensuring Breathing Comfort at the End of Life: The Integral Role of the Critical Care Nurse

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