Respirations

[YoungEMT95]

What is the best way to count patient respirations? I know to watch for chest rise and fall but some patients don't always have visible rise and fall.

[rock_shoes]

Hand over the diaphragm.

Sent from my A500 using Tapatalk 2

[Arctickat]

etCO₂ waveform.

[island emt]

Hold their wrist as in taking pulse. That will keep them from altering their resp rate .

If they know your counting chest rise they won't breath normally.

[Kaisu]

I watch for nostril flare. Sometimes, it you have a sheet or a blanket on their chest, the folds will move too. This is good from the attendants chair because then they are not aware they are being watched. I totally hear you about chest rise and fall.

[rock_shoes]

etCO₂ waveform.

Cheater!

Sent from my SGH-T989D using Tapatalk 2

[P_Instructor]

Respirations are useful for reporting your vital signs. However, the point that should be looked at is if the respirations are adequate for survival of the cells. This along with cardiac perfusion should be monitored much more than the number of breaths per minute. Waveform capnography is cool, but in the initial stages of patient assessment, are the respirations, whatever they may be, adequate enough?

Otherwise, to answer your inquiry, all previous posters have garnered through experience how to count respirations by different techniques, All are good, so try them out and figure what best works for you.

[krumel]

Most useless parameter in emergency medicine....

[BEorP]

Most useless parameter in emergency medicine....

I would have to disagree. You might want to take a read of this: https://www.mja.com.au/journal/2008/188/11/respiratory-rate-neglected-vital-sign

[krumel]

I acutally know similar articles but still disagree.

Respiratory rate does give you an very limited view of the patients respiratory condition as it is directly linked to a parameter that is only very rarely measured in an non-intubated patient: The tidal volume.

Only by the combination of both we have a -more or less- valid view of the -theoretic- oxygenation situation that -might- arrive in the patient. The RR can be measured by a trained monkey...The tidal volume is very often measured wrong or not at all....

The main problems with high -or low- respiratory rate is not the problem of the rate itself (although it of course contributes to the oxygen demand) but the oxygenation deficiency that is a result of it.

We are meanwhile in a position to monitor this oxygen deficiency much closer and with much better tools than we did in when main study that "proved" a link between chance to arrest and RespRate was done (Fieselmann, 1993).

In times were prehospital&ED BGA is becoming more and more of a standard -contrary to the wards- we should not trust a parameter that has a "unknown" variable in it....