How to Measure Respirations Presentation title SUB TITLE HERE

How to Measure Respirations Presentation title SUB TITLE HERE Vital Signs in the Ambulatory Setting: An Evidence-Based Approach Cecelia L. Crawford, RN, MSN

Respiration Measurement - An Overview Equipment for accurate respiratory measurement Watch or clock with second hand or digital second counter Stethoscope Pen or pencil Flowsheet, chart, or medical record Clean hands and fingers! Patient in a comfortable & relaxed position Waited 5 minutes if patient was active Enough time to count the respiratory rate

Respirations – It’s All About The Numbers! Terminal Digit Preference Some people may show a preference for certain numbers in respiratory rate readings* Zeros, even numbers, odd numbers Be aware you might “like” certain numbers more than others! (*Roubsanthisuk, W., Wongsurin, U., Saravich, S., & Buranakitjaroen, P., 2007)

Respiratory Rate Procedure 1. Wash hands & put on gloves, if appropriate 2. Provide privacy 3. Assist patient to a comfortable & relaxed position

Respiratory Rate Procedure 4. Position patient for clear view of chest movement 5. Place patient’s arm or your own hand in a relaxed position across stomach or lower chest 6. Observe a complete respiratory cycle An inhale and an exhale http://www.lane.k12.or.us/CSD/CAM/level1/ASSESS

Respiratory Rate Procedure 7. Count for 60 sec Full minute count for: Children Irregular respirations Very fast or very slow respirations 8. Count for 30 sec and multiply X2 Shorter time counts inaccurate data

Normal Respiratory Rates AGE Newborn to 6 weeks Infant (6 weeks to 6 months) Toddler ( 1 to 3 years) Young Children ( 3 to 6 years) Older Children (10 to 14 years) Adults BREATHS/MIN 30 - 60 25 - 40 20 - 30 20 - 25 15 - 20 12 - 20 (Mosby’s Critical Care Nursing Reference, 2002; Perry & Potter, 2006)

Respiratory Rate 9. Pediatric patients If panting, use stethoscope to count Agitation can result in inaccurate RR

Respiratory Rate Procedure Respiratory rates are NOT a reliable way to determine low oxygen levels! RN and MD assessment is needed

Respiratory Rate Procedure 10. Inform the RN or MD for: Difficult to count respirations Very fast or very slow breathing Irregular breathing If patient seems to be having trouble breathing

Respiratory Rate Procedure 11. Discuss respiratory rate with patient or parent 12. Remove gloves & wash hands

Respiratory Rate Procedure 13. Document the Results Flowsheet, clinic record, or clinic chart 14. Communicate the Results RN MD

Respiratory Measurement in the Clinic YOU can make the difference: Welcoming presence Decrease any anxieties & fears Reassure patients & family Accurate vital signs