The late Dr Rex Hunton demonstrated a technique for asthmatic dyspnoea. It involved standing beside a patient, asking for permission to press on their chest, and then pressing on the middle of their sternum to help them exhale. This uses moderate pressure, not CPR pressure. The asthmatic patients also need to be getting a beta-sympathomimetic simultaneously. This reduces the air trapping and calms the patient (they have panic-fear).
It has also been used for panic attacks. The aim is to reduce the breathing rate to about 6-8 breaths per minute. The pressing and the quiet voice (saying that’s right) are soothing and activate the “vagal brake”, which immediately improves the heart rate variability.1
This is consistent with the polyvagal theory,2 although there is no RCT evidence yet. Reference 2 is a good video for patients.
As published in NZ Doctor and Research Review
