How to Measure Respiration Presentation title Vital Signs

How to Measure Respiration Presentation title Vital Signs in the Ambulatory s Setting: SUB TITLE HERE An Evidence-Based Approach Cecelia L. Crawford, RN, MSN

Respiration Measurement - An Overview • Equipment for accurate respiratory measurement § Watch or clock with second hand or digital second counter § Stethoscope § Pen or pencil § Flowsheet, chart, or medical record § Clean hands and fingers! • Patient in a comfortable & relaxed position • Waited 5 minutes if patient was active

Respirations – It’s All About The Numbers! Terminal Digit Preference • Some people may show a preference for certain numbers in respiratory rate readings* § Zeros, even numbers, odd numbers • Be aware you might “like” certain numbers more than others! (*Roubsanthisuk, W. , Wongsurin, U. , Saravich, S. , & Buranakitjaroen, P. , 2007)

Respiratory Rate Procedure 1. Wash hands & put on gloves, if appropriate 2. Provide privacy 3. Assist patient to a comfortable & relaxed position

Respiratory Rate Procedure 4. Position patient for clear view of chest movement 5. Place patient’s arm or your own hand in a relaxed position across stomach or lower chest 6. Observe a complete respiratory cycle http: //www. lane. k 12. or. us/CSD/CAM/level 1/ASSESS

Respiratory Rate Procedure 7. Count for 60 sec § Full minute count for: § Children § Irregular respirations § Very fast or very slow respirations 8. Count for 30 sec and multiply X 2 § Shorter time counts = inaccurate data

Normal Respiratory Rates AGE BREATHS/MI N Newborn to 6 weeks 30 - 60 Infant (6 weeks to 6 months) 25 - 40 Toddler ( 1 to 3 years) 20 - 30 Young Children ( 3 to 6 years) 20 - 25 Older Children (10 to 14 years) 15 - 20 Adults (Mosby’s Critical Care Nursing Reference, 2002; 12 Perry-&20 Potter, 2006)

Respiratory Rate 9. Pediatric patients § If panting, use stethoscope to count § Agitation can result in inaccurate RR

Respiratory Rate Procedure Respiratory rates are NOT a reliable way to determine low oxygen levels! § RN and MD assessment is needed

Respiratory Rate Procedure 10. Inform the RN or MD for: § Difficult to count respirations § Very fast or very slow breathing § Irregular breathing § If patient seems to be having trouble breathing

Respiratory Rate Procedure 11. Discuss respiratory rate with patient or parent 12. Remove gloves & wash hands

Respiratory Rate Procedure 13. Document the Results § Flowsheet, clinic record, or clinic chart 14. Communicate the Results § RN § MD

Respiratory Measurement in the Clinic • YOU can make the difference: § Welcoming presence § Decrease any anxieties & fears § Reassure patients & family § Accurate vital signs