When Breathlessness Needs Urgent Care

Call emergency services if breathing becomes severely difficult at rest, if lips or fingertips turn blue or gray, if there is chest pressure or pain that does not ease, or if the person becomes confused, very drowsy or faints. Coughing up significant blood and sudden severe breathlessness after a procedure are also emergencies. These can signal rapid fluid buildup, a collapsed lung, a blood clot, infection or a heart problem. Quick assessment gives the best chance of fast relief. If you are unsure whether symptoms are an emergency, it is safer to call for help. Emergency staff can quickly check oxygen levels and look for treatable causes.

Some changes are less dramatic but still need prompt advice. Breathlessness that is noticeably worse than yesterday, needing more pillows to sleep, new swelling in the legs, fever, or reduced output from a home drainage catheter all deserve a call to your care team the same day. Rapid refilling of pleural fluid is common and often treatable with drainage. Early contact can mean a scheduled procedure rather than an emergency room visit. Note when the worsening started and what makes it better or worse, since that helps the team decide how urgently to act. Early calls often prevent more serious problems later.

Keep your care team's daytime and after-hours numbers in your phone and on the refrigerator. Know which hospital your team prefers you use. Keep a current medication list and a short summary of your diagnosis and recent procedures ready to hand to emergency staff. If you have a home catheter, keep supplies stocked and know the drainage instructions. Some patients have a written breathlessness plan from their palliative team that explains what to do at each level of symptoms. Practicing breathing techniques while calm also makes them easier to use during an episode. Review the plan with family so they know what to do too.

1. 1

   Save your care team's after-hours phone number in your phone and on paper at home.

2. 2

   Keep a one-page diagnosis and medication summary ready for emergency staff.

3. 3

   Ask your palliative team for a written plan for managing breathlessness episodes.

4. 4

   Learn how to check a home catheter and when reduced drainage needs a call.