Counting Respirations.

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Specializes in soccer.

How critical is it to count respiration in the hospital? I can understand the need to count respiration if the patient is having difficulty breathing or prior to giving narcotics/painkillers. But is it really necessary if the patient is doing "fine??"

Also, how do you guys count respirations? I am able to count respirations but i cant do it if the patient is talking. During that time...I cannot see the patients "chest" moving up and down. And do you guys count to the full minute? or do you count respirations by the "30-second frame?"

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Specializes in Emergency Dept. Trauma. Pediatrics.

Increased RR from the base or decreased can be a sign of many things, so it is important and it is required in my hospital. Its part of charting the vital signs.

I always had a hard time, what I do, take their pulse longer but count the RR while I am doing it. Usually when I am checking the pulse manually my patients have been quiet so I can do it then, some you can hear and count. Or on some units they use the Pulse ox monitor to get the pulse, so I just act like I am taking it manually so I can get the RR also.

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How critical is it to count respiration in the hospital? I can understand the need to count respiration if the patient is having difficulty breathing or prior to giving narcotics/painkillers. But is it really necessary if the patient is doing "fine??"

Counting an accurate respiratory rate is ALWAYS important. It can clue you in to subtle changes in the patient's condition before you or they are even aware of it! And not only is it critical to check before administering narcotics because of respiratory depression, it can reveal other conditions such as acidosis/alkalosis. Remember -- vitals are just one piece of the picture. You have to use other findings to validate your assessment and put the "whole picture" together.

Also, how do you guys count respirations? I am able to count respirations but i cant do it if the patient is talking. During that time...I cannot see the patients "chest" moving up and down. And do you guys count to the full minute? or do you count respirations by the "30-second frame?"

I always place my fingers over their radial artery and then fold their arm and rest their hand on their chest. That way, I can count the pulse rate and switch over to counting respirations as soon as I am finished without making them aware. Yeah, I'm sneaky. ;) If their hand is resting on their chest, you can watch their hand move up and down -- sometimes that makes it easier. I usually just count for 30 seconds then multiply by 2 if I know this person has no respiratory problems or acute medical issues. BUT if they do have positive history, or if the first 30 seconds I count are irregular or too shallow, too deep, etc,. then I count for 1 full minute.

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Hi there,

I always found it difficult to count respirations in the beginning. Now, I actually count the respirations when I am listening to bowel sounds. Patient tend to be quiet when they see you have the stethoscope and they don;t alter their breathing because they don;t know you are counting their respirations. A friend also told me her trick was to alter her breathing rate to her patient which might help. Still haven't figured a short cut for the babies yet.

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Specializes in Psych ICU, addictions.
How critical is it to count respiration in the hospital?

Very.

Also, how do you guys count respirations? I am able to count respirations but i cant do it if the patient is talking. During that time...I cannot see the patients "chest" moving up and down. And do you guys count to the full minute? or do you count respirations by the "30-second frame?"

How I do it: after I'm done getting the pulse manually, I keep my hand on the patient's wrist and count respirations for 30 seconds (more if they're breathing irregularly). To the patient, it still appears as though I'm taking their pulse...if they ask what's taking so long, I smile and tell them the pulse is hiding from me :)

I find when I have a hand on the patient taking their pulse, pressure, etc., most tend to quiet down on the chatter until I'm finished. The arm on the chest trick is good too.

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Specializes in soccer.

Both the arm and the stethoscope are pretty good tricks. I have never thought of doing that before. Thank you guys. I appreciate the help.

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Specializes in soccer.

I might consider trying to attempt doing both at the same time. "Fake trying to listen to Bowel Sounds" and putting their arm across their chest.

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Ohh... bowel sounds is a good time. In my current hospital, we have disposable thermometers which need to stay in for 1 fill minute. Patient can't talk so I count resps then. ;)

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Specializes in Psych ICU, addictions.
Ohh... bowel sounds is a good time. In my current hospital, we have disposable thermometers which need to stay in for 1 fill minute. Patient can't talk so I count resps then. ;)

Didn't think of the thermometer, that's clever!

We have digital ones though, so at most I could get myself 10-15 seconds.

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