External applications

External applications are valuable in the treatment of dyspnea and bring immediate relief. Through appropriate application and selection of substances they can unblock pulmonary congestion, promote secretion and mucociliary clearance by means of essential oils and have a calming effect on anxiety and tension. In addition, they are effective in improving dyspnea through human closeness, and through receiving a nurse’s care and attention in moments of great distress.

Acute shortness of breath, hyperventilation, panic attacks

Lower leg strokes on both sides

The calf has a connection to breathing. Tension, anxiety and agitation, which are often experienced in the rhythmic system, can be drawn “downwards” into the legs. This application can also be performed on top of the patient’s clothes.

Instructions without oil:

  • Support the knees with pillows.
  • Place a large towel under the lower legs and fold it over the legs and feet.
  • Beginning below the knee, stroke with your outstretched thumb over the shinbone towards and over the toes and continue the movement out into infinity.
  • Stroke both legs at the same time until the calming effect can be experienced.

The person administering the treatment adopts an inner attitude of leaving the other person free. This has a calming effect.

Instructions with oil:

  • The patient lies in a relaxed position on her back, with her knees supported. 
  • A large towel is placed under her lower legs and feet and folded over her shins.
  • The practitioner stands at the foot end of the bed with one foot in front of the other.
  • Take a little oil—e.g., almond or olive oil—in one hand and spread it onto the palms of your hands, warming it up. 
  • One hand strokes along the calf to the heel. The other hand strokes parallel along the shinbone to the ankle.
  • The hand on the heel holds the heel in the hand for a short time. Then both hands continue stroking to the toes.
  • Repeat this 2–3 times. The practitioner then stands to the side of the feet.
  • The foot lies relaxed in the bed. One hand is wrapped around the toes.
  • The other hand makes a wide sole stroke with the ball of the hand. This means that the hand of the practitioner is diagonal to the patient’s foot.

Relatives can be shown an easy helpful measure—how to take the heels of the affected person in each hand and leave them lying quietly there in such situations. Inhale and exhale calmly yourself and adopt an inner attitude that leaves the other person free.

  • This application can also be done with Pallasit D12 ointment WELEDA.

Dyspnea

Ginger kidney compress

Ginger kidney compresses engender the development of strong heat in the kidney area. This has a very relaxing and breath-deepening effect. It also stimulates kidney function.

Contraindications: Psychoses, intolerance to ginger, skin injuries.

Instructions:

  • Spread out a cloth diaper, place a single-layer piece of cellulose or a paper towel in the middle. Spread 2–3 tbsp. (approx. 30 g) of ginger powder over a 20 x 20 cm area. Then fold the cellulose paper or cover the ginger powder with a second paper towel. Fold the cloth diaper with the ginger into an approx. 20 x 20 cm square and roll it up firmly. Wrap this roll in a towel (kitchen towel) to wring it out with and place in a bowl.
  • Protect the bed from moisture with an incontinence sheet. Place a long 40 x 160 cm outer cloth under the patient at kidney level.
  • Pour hot water (approx. 70°C) or horsetail tea over the ginger compress. Make sure that the ends of the wringing-out towel remain dry so that they can be held for wringing. Wring out the compress as firmly as possible so that there will be little cold caused by evaporation.
  •  Remove the cloth diaper with the ginger from the wringing-out towel and place it on a hand towel which is also folded to 20 x 20 cm.
  • Have the patient sit up. Carefully fan the kidney area and place the compress on it. Have the patient lie down on his back again and wrap the outer cloth of the compress around him.

The compress should be left on for about 25 minutes and the patient should be able to enjoy it undisturbed. Then carefully remove the cloth diaper with the ginger and the hand towel. It works best when the patient sits up again a little. Close the outer towel again and let the patient rest for about 30 minutes, as the effect of heat generation can be experienced over the entire body during this time.

The compress leads to deep relaxation in most patients, their breathing calms down. The patient can often fall asleep.
However, many people feel energized and alert after the compress, so this application should not be administered in the evening.

Acute and chronic dyspnea, neck tension, anxiety

Aconite neck compress

  • with Aconite Nerve Oil WALA
    has a relaxing and anxiety-relieving effect.

For instructions, see:

http://www.pflege-vademecum.de/grundlagen-wickel-und-auflagen.php?locale=en

The compress should remain in place for at least 20 minutes. It can also be left on for as long as the patient wishes, as the compress does not get cold.

Contraindications: Intolerance or aversion to aconite oil.

The compress can be prepared and applied quickly in acute situations. The patient can sit and does not need to lie down.

Persistent urge to cough, nocturnal irritable cough, with agitation and mental tension

Lavender thorax compress

  • with Lavender 10% oil WALA/WELEDA
    warms through, relaxes, calms. Apply directly after operations or bronchoscopies for anxious people.

For instructions, see:

http://www.pflege-vademecum.de/grundlagen-wickel-und-auflagen.php

  • with Thyme 5% oil WALA
    relieves irritation and cramping, dissolves tough, stuck mucus, is anti-inflammatory, antibacterial.

A thyme chest compress is particularly suitable when there is a very strong urge to cough at night. Some people are afraid to go to sleep for this reason. Patients with lymphoma often suffer from it.

Materials:

  • Cotton cloth
  • Warming cloth, e.g., cloth diaper or similar, with wool or cotton wool folded into it
  • Outer wrapping cloth or T-shirt to hold it in place
  • Plastic freezer bag
  • 2 hot water bottles
  • etheric 10% oil

Instructions:

  • Sprinkle a cotton cloth with essential oil and place it in a plastic bag.
  • Place the warming cloth and the plastic bag with the oil cloth between 2 hot-water bottles (approx. 70°C).
  • Wrap the outer cloth around it and let it warm up for about 10 minutes.
  • Take the cotton cloth out of the plastic bag and place it on the chest of the patient, with the warming cloth on top of it.
  • Then wrap the chest with the wrapping cloth, alternatively you can simply use a T-shirt or pajamas to fix it in place.

The oil compress should be allowed to work for at least 20 minutes, but it is also well suited to staying on for longer—e.g., overnight—as the compress does not get cold.

It is important to keep the feet warm. If they are warmed with a hot-water bottle before starting the application, the oil compress can also be placed there for warming up. However, it is important that there be no other heat sources on the body during the application.

Terminal secretions

Quark chest compress

As the quark dries during the application, liquids are gently sucked towards it. The tissue is freed of congestion.

Contraindications: Damaged skin.

Instructions:

  • The best effect is achieved with low-fat quark . Apply the low-fat quark with a knife or wooden spatula to an unfolded compress, approx. 3–5 mm thick, and cover with a second compress. The size of the compress depends on the size of the thorax. In general, approx. 15 x 15 cm is sufficient.
  • This is then placed directly on the skin in the front of the chest and fixed in place with a cloth (e.g., a cloth diaper). The compress can remain there for several hours, but can also be left in place overnight. The effect unfolds during the drying process.

The quark should not be too cold, approx. 36°C to lukewarm. This can be achieved quickly if the prepared quark compress is briefly placed on a hot-water bottle (a plastic bag is suitable as protection). The quark must also not be heated above 40°C, otherwise the milk protein will curdle.

The patient’s breathing usually calms down after just a few minutes.

Dyspnea in COPD, asthma; emphysema; pneumonia prophylaxis

Lung organ embrocation

For respiratory stimulation and deepening, relief for spastic respiration.

Watch your breathing—“breathe along” with the patient—then, gradually slow down your own breathing! A lung embrocation is divided into four phases: 1) back stroke, 2) change of direction, 3) forward stroke 4) through the air back to the beginning.

Use:

  • Plantago Bronchialbalsam WALA

Composition: D-Camphora, Cera flava, Drosera e planta tota D3, Eucalypti aetheroleum, Petasites hybridus e radice D1, Plantago lanceolata e foliis D1, Terebinthina laricina, Thymi aetheroleum

  • Lavender oil, e.g. WALA/WELEDA
  • Thyme oil WALA
  • Pine needle oil, e.g. Pinus pumilio, Oleum aethereum WALA
  • Bronchial balsam WELEDA

Composition : eucalyptus oil, sweet fennel oil, spruce needle oil, peppermint oil, rosemary oil, Dalmatian sage oil, juniper oil
 or

  • Eucalyptus oil WALA

Dyspnea with agitation, anxiety, accompanying cardiac symptoms

Ointment heart compress

  • with Aurum/Lavandula comp. WELEDA (also available as Aurum/Lavender/Rose ointment)

Composition: Aurum metallicum praeparatum D4, Lavandulae aetheroleum, Aetheroleum extractum e floribus recentibus Rosae damascenae et centifoliae

Gold combines the qualities of light and heaviness and harmonizes experiences of soul and spirit. Lavender has a balancing, harmonizing and relaxing effect. Lavender oil causes gentle warming and its fine scent is perceived as being very pleasing. It relaxes the breathing.

Instructions:

  • A double-folded cotton or linen cloth is used as the substance cloth. This cloth is cut to the size of a chest compress (usually approx. 15 x 15)
  • Natural sheep’s wool wrapped in a non-sterile compress can be used as padding.
  • Fasten the substance cloth to it with adhesive tape.
  • Apply the ointment thinly onto the substance cloth so that a glossy mirror can be seen on the cloth (similar to buttered bread).
  • Warm the compress slightly with a hot-water bottle or place it folded under the patient’s shoulder.
  • As soon as the compress is warm, unfold it and place it on the patient’s chest.
  • The compress can stay on for at least 1 hour, but also the whole night.
  • The compress can be freshly coated with ointment several times. As long as the cloth smells good (approx. 14 days), it can be stored in a (food safe) plastic bag in a place protected from light.

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Fingado M. Rhythmische Einreibungen. 4. Aufl. Dornach: Verlag am Goetheanum; 2012.

Fingado M. Therapeutische Wickel und Kompressen. 5. Aufl. Dornach: Verlag am Goetheanum; 2012.

Batschko EM. Einführung in die Rhythmischen Einreibungen. 2. Aufl. Frankfurt: Mayer im Info 3 Verlag; 2010.

Hauschka M. Rhythmische Massage. Bad Boll: Margarethe Hauschka Schule; 1996.