Respirations Review | Assessment Keys

Respiration breathing provides a way for the body to exchange oxygen and carbon dioxide. Respiration is automatically controlled by the brain. A variety of factors can influence respiration. such as:

Head injury, depressed with elevation of intracranial pressure bleeding

Increased respirations with significant blood loss

Stress, rapid rate, and increased depth.

Fever, increased rate.

Hypothermia, slower rate, and shallow breaths.

Medications. Narcotics in large doses can depress both rate and depth.

Voluntary control can also effect breathing up to a point. To avoid voluntary changes in rate or depth. It is best to count the respirations in such a way that the patient is not aware they are being counted.

Start by taking the pulse of the patient while you are holding the patient’s wrist and looking at your watch, use your peripheral vision to observe the rise and fall. Many experienced examiners will actually take the respiratory rate first, even though they are holding the wrist and appearing to take the pulse.

Ideally, the respirations are observed for a full minute and reported as RR equals 16. Meaning respiratory rate equals 16 respirations minute. Often respirations are observed for only 30 seconds and the results doubled to give the respiratory rate per minute. If pressed for time, respirations can be observed over 15 seconds and quadrupled to give the RR.

The normal respiratory rate in adults is 12 to 20 respirations per minute. If the patient’s rate is outside those limits, it may indicate a significant pathological process. Normal respirations are deep and even. The ribcage expands fully and the abdomen rises and falls.

Abnormal breathing includes deep breathing, shallow breathing and rapid breathing. Abnormal respirations may be irregular due to illness or injury. If the patient experiences difficulty in breathing, there may be associated noises such as wheezing, rattling, or bubbling. The patient may be more comfortable sitting up or leaning forward. They may appear restless and anxious. Their skin can be pale ashen or cyanotic.  

A good assessment of patient respiratory rate and quality will help you decide proper treatment paths for you to take.

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