Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Breathing and Relaxation Techniques

Control Your Breathing

Remember: Breathlessness on effort is uncomfortable but not in itself harmful or dangerous. Knowing how to control your breathing will help you to remain calm when you are short of breath. Pursedlip breathing and diaphragmatic breathing will both help if you have COPD. These breathing methods prevent or reduce the trapped air in your lungs, and allow you to inhale more fresh air.

Pursed-Lip Breathing

  • Breathe in slowly through your nose for 1 count.
  • Purse your lips as if you were going to whistle.
  • Breathe out gently through pursed lips for 2 slow counts (exhale twice as slowly as you inhale) - let the air escape naturally and don’t force the air out of your lungs.
  • Keep doing pursed lip breathing until you are not short of breath.

Diaphragmatic Breathing

  • Put one hand on your upper chest, and the other on your abdomen just above your waist.
  • Breathe in slowly through your nose – you should be able to feel the hand on your abdomen moving out (the hand on your chest shouldn’t move).
  • Breathe out slowly through your pursed lips – you should be able to feel the hand on your abdomen moving in as you exhale.

Positions to Reduce Shortness of Breath

  1. Sitting: Sit with your back against the back of the chair. Your head and shoulders should be rolled forward and relaxed downwards. Rest your hands and forearms on your thighs, palms turned upwards. DO NOT LEAN ON YOUR HANDS. Your feet should be on the floor, knees rolled slightly outwards. Do S.O.S. for S.O.B. until breathing is normal.
  2. Sitting: Lean back into the chair in a slouched position, your head rolled forward, shoulders relaxed downward. Rest your hands gently on your stomach. Keep your feet on floor, knees rolled outward. Do S.O.S. for S.O.B. until breathing is normal.
  3. Sitting: Place a pillow on a table and sit down, arms folded and resting on the pillow. Keep your feet on the floor or a stool, and rest your head on your arms. Do S.O.S. for S.OB. until breathing is normal. This position may also be used standing, arms resting on kitchen counter or back of chair, NOT LEANING, knees bent slightly, one foot in front of the other.
  4. Standing: Lean with your back to the wall, a pole, etc. Place your feet slightly apart and at a comfortable distance from the wall, head and shoulders relaxed. Do S.O.S. for S.O.B. until breathing is normal.

S.O.S. for S.O.B. (Help for Shortness of Breath)

When on the brink…..think

  • Stop and rest in a comfortable position.
  • Get your head down.
  • Get your shoulders down.
  • Breathe in through your mouth.
  • Blow out through your mouth.
  • Breathe in and blow out as fast as is necessary.
  • Begin to blow out longer, but not forcibly – use pursed lips if you find it effective.
  • Begin to slow your breathing.
  • Begin to breathe through your nose.
  • Begin diaphragmatic breathing.
  • Stay in position for 5 minutes longer.

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