How do you eyeball respiratory rate effectively?

vintagemother, BSN, CNA, LVN, RN · Jan 30, 2018

If I can't see the RR, I place my hand on their chest. That way I can feel the rise and fall.

Regarding not telling them you're counting the RR...I typically hold their wrist as if I'm counting the radial pulse at the same time.

Accordiantoyou · Jan 30, 2018

I wanted to do the hand on chest or back thing but we haven't been taught that yet and will be marked off.

PeeWeeQ, ADN, RN, EMT-B · Jan 30, 2018

Most people, other than young 'uns, aren't belly breathers, so, that usually won't be accurate anyway. Some people are just easier to read than others. The ones that are tripoding and using accessory muscles are easy. I've been an EMT for years and I've found that the best way is to hold your hand nonchalantly on their back when you are doing something else like pulse (the best one), taking temp, or any other creative but appropriate thing you can come up with. I've been spoiled in EMS because you could usually find some way to feel or observe it when there are one or more EMTs in the room distracting the PT. All that said, I've had to stick with a simple definition like "slow and deep" or "rapid and shallow" without a number because, if you tell them you're doing it, they are going to think about it. Then you just don't know...

verene, MSN · Jan 31, 2018

I wanted to do the hand on chest or back thing but we haven't been taught that yet and will be marked off.

In that case ask your instructor how they want you to count respiration when you can't clearly see. The hand on back or chest tricks are pretty common. You can also count under the guise of listening to heart sounds or taking an apical pulse, but I'm guessing you haven't been taught those either?

ItsThatJenGirl, CNA · Jan 31, 2018

I wanted to do the hand on chest or back thing but we haven't been taught that yet and will be marked off.

I put one hand on their back, while taking the pulse. So you can't really tell that I'm counting their respiration rate.

FSZ Student Nurse, RN · Feb 1, 2018

Yeah, I also had that problem! And, yeah, I did what all the PPs have suggested: put a hand on the patient's back or shoulders.

Your instructor might not have "taught" you to do it that way, but that doesn't mean s/he won't accept it. Just ask! My instructor was fine with it; I think she just forgot to mention we could do it because it seemed to so obvious to her.

If your instructor doesn't let you touch the patient to count RR, then first look at the patient carefully. Most people will have some part of their body that moves visibly when they breathe. Look at the neck, back, shoulders, chest. Take the time to figure out what you will focus on before you start counting.In your case, you found that your classmate's back was a great place to focus on. So you would try to position yourself so you can see her back when you are counting.

Something I've figured out is that it sometimes helps to look at them "in profile", i.e. don't focus on their body, but look where their chest is in relation to a landmark that is behind it and then watch for that to get blocked by the chest expansion... I don't think I explained that so well

Good luck in Nursing School!

Shawn91111 · Feb 1, 2018

If I can't visually see their chest rise, I have them place their hand on their chest while I am checking their pulse on their other arm