Just like food and water, the human body also requires oxygen in order to sustain life. Unfortunately, compromised respiratory conditions as presented by those with a variety of potential injuries, can have a negative effect on respiratory rate and can therefore affect the delivery of the critical components of oxygen to the cells, tissues, and organs that need it the most. As an element of a patient or victim's vital signs, through the obtainment and subsequent recording of a respiratory rate, first responders and medical personnel can use this piece of data (in conjunction with other pieces of data) in order to determine what is wrong with the person.
Follow the steps, in this Info Barrel article, to effectively measure and record the respiratory rate of a patient or victim that you are attending to.
Things You Will Need
- a Pen or Pencil
- a Notebook or Piece of Paper
- a Watch (or Stopwatch)
Step 1When conducting any kind of assessment, whether you are comparing two extremities or measuring and recording a patient or victim's respiratory rate, a significant amount of data can be acquired simply by observing. Before you even place your hands on a person, you should take the earliest opportunity in your response to observe and evaluate the nature and depth of the injured person's breathing. In order to do this, you should place your head, near the patient's head, and observe for subtle (or exaggerated) fluctuations (or rising and falling) of the patient's stomach and chest.
When anyone breathes in, whether deeply or shallowly, this is called "inspiration". When a person breathes out, this is called "expiration". Both functions are critical in sustaining a human's life, as "inspiration" is required to bring oxygen into the body, and "expiration" is required to blow off carbon dioxide, which is a waste product of respiration. When observing these functions, any deviation in what you are accustomed to seeing as 'normal' should be documented. Pay particular attention to the nature, depth, and rate of the victim or patient's respirations.
Step 2In order to determine a patient's respiratory rate, there are several approaches that can be taken with respect to a minute time frame. For those with previous known respiratory conditions, it may be necessary to ensure a greater degree of accuracy by counting all the rising and falling, of the patient's chest or stomach, that occur within a 15 second period. When the total number of respirations is multiplied by four, you will obtain the number of respirations per minute. For those with very complex respiratory conditions, you may even want to consider conducting this count for an entire minute straight in order to account for incredible fluctuations regarding inconsistent labor and depth of the patient's breathes. Not all people will have consistent, predictable, breath patterns, so, for these people, counting respirations for a full minute straight can certainly lend to maximized accuracy.
The respiratory rate per minute can also be achieved by counting the rise and fall of a patient's chest or stomach for 30 seconds straight, as well. In this situation, you respiratory rate count with simply be multiplied by 2 in order to achieve the patient's respiratory rate per minute.
Step 3While you are counting a patient's respiratory rate, you should also take note the rhythm of their respirations. Fluctuations and inconsistencies in rhythm, as mentioned above, may occur in those with chronically compromised respiratory conditions like emphysema or sarcoidosis. Cancers of the lung may also lend to these fluctuations in respiratory rhythm, as well. Along with the rhythm of a patient's respirations, you should also take note of the effort required to breathe. Is a patient's breathing labored or effortless? Both could indicate either a need for further intervention or a stable patient that simply needs to be monitored.
Step 4Beyond simply observing the characteristics of effective breathing, a first responder's senses can also play a tremendous role in obtaining critical information that can help to substantiate further diagnosis and help to provide immediate care on the scene. If any odors are detected, that deviate from 'normal', such as a fruity, acidic, or fecal smell, these smells should be documented as well. These odors could indicate the presence of further illness or disease that may be able to be treated.
Step 5If you are responding to a patient or victim at the scene of an accident, you may not have all the time in the world to take notes and document your observations. In this case, you may simply have to 'remember' what you saw, and recall it once the patient is stable. Documentation, whether on a notebook or a piece of loose leaf paper, should include all the previous characteristics of effective breathing in a concise and systematic manner.
You should begin by documenting a patient's breath rate, rhythm, effort, depth, noise, and, lastly, odor. Noises heard may include gurgling or whistling-type sounds that could indicate narrowing of the airway passage.
Step 6Within your documentation you will including objective data, which essentially means the data that you have obtained through observation. Do not forget that vital data can also be obtained by simply asking the patient for a self-report regarding how they feel and what happened. Oftentimes, simply asking a patient how they feel may go overlooked and underutilized by medical professionals. In this case, all your observations may indicate that a patient or victim should be fine, however, they may not be if they give you a negative self-report that involves excruciating pain that impedes their breathing.
Whether you are a nurse, doctor, first responder, or general layperson, it is importantly to realize that there are many elements and characteristics to documenting effective breathing. Where a patient or victim may have a 'normal' respiratory rate, other characteristics of breathing may be 'off' and may indicate some sort of problem or worsening of a patient's condition. If a patient has a 'normal' respiratory rate, yet they have very shallow breathing, they may very well not be obtaining the oxygen required to adequately and effectively maintain homeostasis.
Tips & Warnings
If you ever come across a casualty or a victim, be sure to be conscience of the fact that a spinal chord injury could have always occurred. For this reason, it is important not to excessively jerk or touch the patient's neck area. While the neck can be extended in order to facilitate greater depth of respiration, doing this could further jeopardize a spinal chord that may already be compromised. In this case, stability is important while you assess for all the characteristics of effective breathing.
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