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Having trouble counting respirations and finding pulse

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by ARRR10 ARRR10 (Member)

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I had a practice lab last week on vital signs and I sort of had a hard time counting respirations and finding the pulse on one of my lab partners (I'm sorry to say this, but her arm was kind of large and and I was applying already so much pressure but still couldn't find the pulse). Also, when I try to count respirations, I try to do the method that the textbook recommended (which is placing the patients hand over the chest while doing a second set of counting pulses) but I could barely count anything, because her breathing was very faint. Anybody know an easier method of counting pulses and respirations on clients (also those with a large body frame)?

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32 Posts; 1,099 Profile Views

Well you can always put your hand on someone's back to help count respirations.

As for pulse.. but def go for the radial. If you can find that tendon it's on the side of the thumb.. easy to find the pulse then.

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spoiled_lil_sister specializes in Telemetry.

79 Posts; 2,326 Profile Views

I'm not sure if you are allowed to do this in lab or not, but I use my stethoscope to get a large patient's apical pulse & respirations at the same time, like taking a second radial pulse when counting respirations. If I attempt a radial pulse & either cannot feel it or cannot see their respirations & need to auscultate them, I just tell them something cheesy like "great - I can feel & hear your pulse just fine" as if I was comparing them. They think they are getting special attention or something...

Hope this helps!

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Thedreamer has 4 years experience and specializes in PCU/Hospice/Oncology.

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Maybe its my EMT background but I learned to just take 15 seconds, get a radial and count respirations at the same time, multiply by 4, and theres your bpm and rpm. Works for me!

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aerorunner80 has 8 years experience and specializes in NICU.

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We use vital machines typically to get all our signs except for resp. Sometimes the machine doesn't pick up pulse and I do have to take it manually. If I try one wrist, say the right one, and don't feel anything or I find it but it's so weak I only feel every other beat or so, I'll ask the pt if they are right or left handed. If they are right, I will then try the left and I almost always am able to feel it there. If that doesn't work, I will take a carotid pulse.

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loriangel14 is a RN and specializes in Acute Care, Rehab, Palliative.

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Sometimes applying too much pressure can occlude a radial pulse. I used to have this problem. Also try finding the notch beside the tendon on the thumb side of the wrist to locate for the radial pulse. The suggestion putting one hand on the back is an excellent one for counting resps. Also your lab partner may have been conscious of you trying to count and tensed up making her breathing shallow.

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1,927 Posts; 14,513 Profile Views

I've found that sometimes applying too much radial pressure makes it harder to feel. Also, I'm sure there are many of us who only count for 15 seconds and multiply by 4 but I wouldn't recommend doing that in clinicals. Reason is that pulse and respirations can be irregular, especially if they're circling the drain.

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