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Originally posted by LarryGOn some patients, it's difficult to see their chest or belly moving.
How do you more experienced folks solve the prob?
Thanks in advance!
Larry when you take the pts. pulse rest their wrist and lower arm on their chest or stomach. When your done checking the pulse leave everything where it's at. Now you should have some tactile function to help you along with being able to watch the arm now rise and fall.
I sometime place my hand on thier back between or near the shoulder blades. I put my hand on a shoulder with most of the hand resting on the posterior side. I can usually detect respers here. I may place their arm across their stomach with my hand on their radial pulse of that arm. I will count respers while I pretend to do something else. If they are VERY regular you can sometimes get a cout in 15 sec. However, I perfer to count longer.
I can usually catch the respirations while listening for heart tones and bowel sounds. This way the patient is breathing normally and if their respirs are hard to catch I can hear them.
Our techs usually do the pulse with a machine. But sometimes I'll do the trick like others and grab the radial while I'm really counting respirs. I certainly am not talented enough to count respirs and pulse at the same time. I do one then the other.
with lots of experience I can accurately estimate resp rate between 16 - 20/min, just by watching them while I talk. If out of range, or any resp complaint I count, 15, 30 secs, whatever it takes to get it accuate. The really tough ones are the babies, Yikes they go up and down, I sometimes have to count for more than a min, esp when they are screaming!!
Havin' A Party!, ASN, RN
2,722 Posts
On some patients, it's difficult to see their chest or belly moving.
How do you more experienced folks solve the prob?
Thanks in advance!