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Should you routinely record respiratory rate? What do you think?
EXPERT COMMENT
Measurement of respiratory rate should be undertaken meticulously, following local protocols and EWS guidelines. It is necessary to count the number of respirations in a minute. If patients realise their breathing is being watched, the rate may actually increase. To avoid this, healthcare professionals can pretend to check the radial pulse while, at the same time, counting the respiratory rate.
Indications include:
- Critical illness: it is an important component of the ABCDE approach;
- Ascertaining a baseline respiratory rate for comparison;
- Monitoring changes in oxygenation or in respiratory rate.
- Evaluating response to treatment, for example, following administration of a beta-2 agonist in the treatment of asthma.
- Jevon P (2010) How to ensure patient observations lead to prompt identification of tachypnoea. Nursing Times;106: 2, 2010.
Author Phil Jevon is resuscitation officer and clinical skills lead, Manor Hospital, Walsall.
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Readers' comments (8)
Anonymous | 26-Sep-2011 5:46 pm
Yes, of course you should. It is often the respiratory rate that is out of normal range first when a patient deteriorates.
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Anonymous | 27-Sep-2011 10:57 pm
When a patient is in pain or has a chest infection it can be a high respiratory rate that manifests before all the other signs. It doesn't take long to do anyway so it would be lazy to just not bother.
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Anonymous | 1-Oct-2011 9:39 pm
If I don't have time to do it properly then I just guess, especially if they're talking to me and making it difficult. If there is other observations out of whack I do it properly. But comparing it to any baseline is flawed because that's probably been made up too! At the end of the day, for whatever reason, we are worked like dogs and something has to give.
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Anonymous | 2-Oct-2011 2:48 am
Anonymous | 1-Oct-2011 9:39 pm - what kind of shady nurse are you? busy or not, you cannot simply guess vital signs, especially not something as import as respiratory rate, it will tell you so much about a patients state and stability. And it's pretty cynical to think that the baseline will be flawed anyway. In my opinion you are an embarrassment to nursing.
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Anonymous | 2-Oct-2011 8:28 am
completely agree with anon 2:48am. i had a days course on my staff nurse developement programme that went through the whole of the EWS. it was brilliant and i learnt a lot from it and now am so rigourous with my observations now. i personally do my observations.all the HCAs are aware and i am one of a few nurses on the ward who do, how ever busy i am. not having a wash won't kill my patient but a high EWS could. all i can say is i'm glad i dont work with anon 9:39pm
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Alice P | 3-Oct-2011 1:10 pm
Anon 8:28 - you might work with someone with that attitude, how would you know? Instead of dismissing it, we should look to make sure all our colleagues do understand the importance of accurate measurement of respiratory rate. A simple check would be to see if all rates are even numbers. If they are marking a full minute, then some would have to be odd, yes?
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Jacqueline Hickman | 3-Oct-2011 1:16 pm
Anonymous 2-Oct-2011 2:48 am & 8:28 am. You have both said it all.
Anonymous 1-Oct-2011 9:39 pm, give up nursing! Which other vital signs do you " just guess"?
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Anonymous | 3-Oct-2011 1:21 pm
The notion of guessing any vital signs is extremely dangerous and negligent. I totally understand that work pressure is particularly high in nursing. However, this does not excuse unacceptable levels of nursing care. If the patient was you, your spouse or a member of your family, you would be distraught to find out that your nurse simply "guessed" vital signs. Carelessness can have a life-threatening impact on patients.
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