counting respirations

[djb1284]

i am a new nurse. i have trouble counting respirations. a lot of the time i cannot see the chest rise and fall. can someone give me some hints, please

[classicdame, MSN, EdD]

put your fingers on the abdomen. You should feel it move. Try it on yourself first.

[HeartsAndLungsRN]

If I cannot see chest movement, I count after the apical pulse. I keep my stethoscope on the patient so I can feel the chest move and I know they are accurate because the patient doesn't realize that's what I am doing.

[smf0903]

If I cannot see chest movement, I count after the apical pulse. I keep my stethoscope on the patient so I can feel the chest move and I know they are accurate because the patient doesn't realize that's what I am doing.

This is exactly what I do. I move it sometimes if I am having trouble hearing the breath sounds at the apical site. One day at clinicals I moved my steth to the right side of the chest and was listening to count respirations and my instructor came in. She had this horrified look on her face , and I knew EXACTLY what she was thinking. Without her asking I said "No I am not counting apical", and she looked so relieved LoL!!

[Lev, MSN, RN, NP]

Arm on shoulder or watch the abdomen rise and fall.

[nurseprnRN, BSN, RN]

Lean over the person to use your stethoscope and feel the breath on your cheek.

[NuGuyNurse2b]

+ 1 on the apical pulse trick. Also, it's easier to count on a female client cause you can see the chest rise, for a male client, I generally look at the abdomen for the rise/fall.

[BusyBee91]

For my EMT vitals, we were taught the *trick* about taking a radial pulse while holding the pts wrist over their chest. take pulse for 30sec, and then you should be able to feel the chest rise for the next 30. You can get a more 'accurate' respiratory rate if they don't know that you are taking it. You can just tell them, "I'm just going to check your vital signs for about a minute." And they are typically pretty compliant/complacent about it, in my exp.

[Christy1019, ASN, RN]

Lean over the person to use your stethoscope and feel the breath on your cheek.

Lol maybe it's just me but I typically don't want to feel my patients breath on my face

Lean over the person to use your stethoscope and feel the breath on your cheek.

Ewww.

I work in the ED and there just aren't very many patients whose breath I'd be willing to have on my face... and in my zone of maximal inhalatory pressure....

Back of the hand, perhaps, cheek... never.

And if they're awake, alert, oriented, speaking in full and complete sentences with a strong and projecting voice and not complaining of being SOB... RR=16...

And newer cardiac monitors will often give you accurate respiration rate if the patient isn't hyperkinetic nor tremulous...

And if you're really concerned, and well-equipped, nothing surpasses an end-tidal CO2 detector to determine time-averaged and instantaneous respirations.