Respirations

[Kaisu]

You must admit that a respiratory rate of 30 is indicative of an issue as opposed to a rate of say 16, as is a rate of say 6

[krumel]

Completly true..But it still gives you nothing without a lot of Hx and some guesses..... I know patient having a resp of 30 for 25 years...without issues that are anyhow relevant for emergency medicine most of those 25 years.

On the other hand: If I (who has a normal RR of 6-8) would have a Resp of 30 something is reallllllly wrong...

[Arctickat]

Yeah, and I've also known little old ladies who have had a heart rate on the 30-40s for years with no ill effects. Or my father whose resting BP was usually 90/50. We didn't put the LOLs on a pacer, or give my dad a fluid challenge. That doesn't mean that we should invalidate every vital sign taken just because the minority of people are outside the norm. This is why we obtain a patient history in the first place.

We're expected to be able to use our brains when we assess a client, not just disregard a vital sign because we don't like what it tells us and getting a patient history is just common sense.

[P_Instructor]

We're expected to be able to use our brains when we assess a client, not just disregard a vital sign because we don't like what it tells us and getting a patient history is just common sense..

Thank you!!!

[AnthonyM83]

Completly true..But it still gives you nothing without a lot of Hx and some guesses..... I know patient having a resp of 30 for 25 years...without issues that are anyhow relevant for emergency medicine most of those 25 years.

On the other hand: If I (who has a normal RR of 6-8) would have a Resp of 30 something is reallllllly wrong...

Uh, that's why assessment of respirations includes more than just rate and tidal volume. Rate, Rhythm/Pattern, Effort/Quality, and Depth, combined with history

Similar to pulse Rate, Rhythm, Quality or skin Color, Temperature, Moisture, all having to be combined with history.

I don't understand how respirations are so much different? (Respirations meaning an evaluation on the different qualities of respiration, not just rate or just depth etc)

[Secouriste]

To answer the original question, when a patient show little or no visible chest moves, I can put my hand on the diaphragm or lower, on the belly. That works very well. Or else, if I don't want to have physical contact I look at the clavicles and listen to the breathing sounds.

You can combine many things to be sure, but personally I don't like the patients to know I'm checking their breathing, they act less natural.

I agree with Anthony that what matter isn't just one parameter, but all the coherent signs of a distress. I tell my fellow EMTs that we're always looking for a "body of proofs" or a "set of signs".

[1EMT-P]

I would recommend that you try laying the patients arm across their chest area while doing their pulse, count for 30 secs for pulse, then another 30 for resps & mutiple x2.

[ambodriver]

Most useless parameter in emergency medicine....

[FireEMT2009]

For me, I always try to see if you can see the chest rise and fall, and yes some patients might not have a very noticable chest rise and fall, or they might have some very thick/multi-layer clothing on. If you are sitting on the captain's chair or bench seat you can see respirations looking at the clavicle area, you should see some movement. Also, look at the stomach, some patient's stomach will rise and fall with their breathing. Just suggestions.

[Vorenus]

Uh, that's why assessment of respirations includes more than just rate and tidal volume. Rate, Rhythm/Pattern, Effort/Quality, and Depth, combined with history

Similar to pulse Rate, Rhythm, Quality or skin Color, Temperature, Moisture, all having to be combined with history.

I don't understand how respirations are so much different? (Respirations meaning an evaluation on the different qualities of respiration, not just rate or just depth etc)

The question posed at the beginning of the threat was dedicated to repiratory rates, though, and that`s what krumel meant, I think.

And the respiratory rate alone, I gotta agree there with krumel, doesn`t poses such an impressive or precise marker (which is what krumel meant I guess).

Fair enough, very low and very high most likely indicate a problem in a patient - but it`s not "accurate" as let`s say SpO2 or RR, which pose a variety of interpretations.

I`m only talking `bout respiratory rate as the quantitative date in itself here, not about possible lung sounds, position of the conscious patient while breathing, possible pathologic patterns, etc.

Apart from that, although skin-colour, temperature and moisture might be connected to your discovery of a pahologic pulse, they may be totally unrelated to that particular vital measurement and attached to an underlying or secondary problem.