Best tips for counting respirations ??

[Anxiousandafraid]

Hello I’m struggling with doing respirations. At times I would do 30 seconds and if the timer stopped as a person finished inhaling but NOT exhaling I would still count that by 2. Meaning if they had 8 FULL respirations and that last inhale I would end up with 17 as a RR. Someone told me this is wrong. Then I would have my timer end as someone was MID exhale (their tummy would still be decreasing as the timer stops ) … I was told this is also wrong and can’t be counted because they were still exhaling. Please help me in what I can and can NOT count as a respiration. It’s simple I know but seriously stressing me out. 

[dianah, ASN]

I did a quick Google search and what the Youtube and other sources agree with: count each rise and fall as ONE respiration.  Review the multiple sources available (I used "nursing how to count respirations" and, again, got many sources).  Good question!

[macawake, MSN]

On 5/4/2022 at 1:54 PM, Anxiousandafraid said:

Hello I’m struggling with doing respirations. At times I would do 30 seconds and if the timer stopped as a person finished inhaling but NOT exhaling I would still count that by 2. Meaning if they had 8 FULL respirations and that last inhale I would end up with 17 as a RR. Someone told me this is wrong. Then I would have my timer end as someone was MID exhale (their tummy would still be decreasing as the timer stops ) … I was told this is also wrong and can’t be counted because they were still exhaling. Please help me in what I can and can NOT count as a respiration. It’s simple I know but seriously stressing me out. 

Hi there! I applaud your conscientiousness and desire to be as accurate as possible. If I understood your post correctly, a coworker said you were wrong to count the respiratory rate as 17 in the described scenario, and that you should have noted an RR of 16 instead?  I hope that the following might help decrease your stress and anxiety. 

What if a patient has a respiratory rate (per minute) of four and you count it as five… or if a patient has a respiratory rate of 14 and you count 15… or a patient has a respiratory rate of 30 and you count 31.. Would your ”miscalculation” drastically (or even at all) alter what actions/care would be necessary/appropriate for any of these three hypothetical patients? 

Another small thing worth keeping in mind.. Human beings are human ? and not machines. A person may well take 14 breaths one minute and 15 the next. 

[MunoRN, RN]

I agree with Macawake and applaud your conscientiousness.  I also agree that the difference between 16, 17, or 18 respirations per minute is not a clinically significant difference.

But just mathematically speaking, if you're measuring respirations per minute by extrapolating the number of respirations in 30 seconds, then you are correct that the half-respiration should be counted; 8 and a half respirations over 30 seconds equals 17 per minute.  The nurse who told you that isn't correct is an embarrassment to grade school level math teachers.