OASIS Alert

Know which questions to ask for an accurate assessment.

To make certain you score M1400 -- When is the patient noticeably Short of Breath? correctly, Fazzi and Associates suggest these techniques in the OASIS-C Best Practice Manual.

• Start of care (SOC);
• Resumption of care (ROC);
• Follow-up (FU); and
• Discharge from agency -- not to inpatient facility (DC).

• Have you been short of breath in the last 24 hours?
• Which types of activities make it hard for you to breathe?
• Do you ever have to stop what you are doing and sit to catch your breath?
• Do you ever wake up having trouble breathing?
• How many pillows do you use at night?

1. Your patient must perform some activity and movement in order to evaluate the level of exertion required to produce shortness of breath. Watch for shortness of breath throughout the assessment process and note the level of exertion which causes it.

2. If the patient is chairfast, evaluate him by listening to him talk and watching him wheel to another room, reach for items, and perform transfers. Evaluate bedbound or chairbound patients while performing activities of daily living and at rest.Then select the corresponding level of exertion which produces shortness of breath.

3. Select response 4 -- At rest (during day or night) if shortness of breath occurs while the patient is supine (orthopnea).

4. Your M1400 response should exclude sleep apnea unless it is accompanied by an episode of shortness of breath.

5. Verify all patient-reported information with the caregiver.