Measuring respirations

The respiratory rate is the number of breaths that a patient takes each minute. The rate

should be taken when the patient is at rest, and it is assessed by counting the number of times

the chest rises in one minute. Common factors that influence respiration rate are as follows:

Age

Emotional status

Air quality and altitude

Exercise

Internal temperature

Disease (i.e., cardiopulmonary)

O2 and CO2 level (i.e., pulmonary status)

Effectiveness of breathing pattern

Respiratory rate has been measured using 15, 30 and 60 second counts; however, the 60 second

count is most accurate as shorter durations often overestimate the number of breaths per minute. In

a pediatric study, respiratory rates counted with a stethoscope as opposed to visually were 20-50%

higher and more accurate suggesting that only larger tidal volume breaths tend to be counted

visually and rapid shallow breaths may be missed.

Gambar 1

Agitation, anxiety and fever may cause an elevation in respiratory rate not associated with

respiratory distress. Average resting respiratory rates by age:

Common respiratory values are listed below.

Age Breaths per minute

Infant 30 or more

Child 22-28

Adolescent 16 -20

Adult – normal 14-18*

Adult – abnormal <10 and >20

*It has been shown that women typically have higher respiratory rates than men.

Among the conditions that can change a normal respiratory rate are asthma, anxiety,

pneumonia, congestive heart failure, lung disease, use of narcotics, or drug overdose.

IMPORTANCE OF RESPIRATORY RATE

The respiratory rate and tidal volume vary in response to metabolic demand and increase with

physical activity or in disease states such as infection. Importantly, the magnitude of the

metabolic demand is reflected in the respiratory rate, and patients with an elevated respiratory

rate often have a more serious illness.

Rapid breathing is called “hyperventilation”. Shallow (slow) breathing is called

“hypoventilation”. There are many factors that affect the respiratory rate: age, gender, size

and weight, exercise, anxiety, pain, the effect of some medicines, smoking habits and

excitement level are among them. A ‘normal’ respiratory rate for a man is about 14 to 18

breaths per minute and for a woman 16 to 20 breaths per minute, but it’s more important to

know what is ‘normal’ for the individual, and to assess changes from that level.

Some possible findings are:

deep and rapid breathing, which may suggest anxiety

shallow breathing, which can be brought on by some medicines

minimal chest movement, sometimes seen in asthma

the person struggling for breath, characteristic of long-term lung disease or the sudden

onset of a new lung or heart problem

mouth breathing, which might indicate a blocked nose

pain on breathing, which could indicate a cracked rib, chest infection or a tumour in

the lung

noises on breathing: normal breathing is practically soundless, so noisy breathing –

whether it is wheeze, crackles or gasps – can indicate a problem

delayed breaths, where the time span between breaths varies: this can be a normal

sign in older people, but could also indicate problems with the heart or brain.

The patient’s/client’s skin colour is also important as an indicator of how well their

respirations are working. Patients/clients who are not getting enough oxygen can develop a

bluish tinge called ‘cyanosis’ which can be seen in their skin, nail beds, earlobes and the

lining of the mouth (in people with dark skin, it’s most noticeable in the lips and nail beds,

which become dusky). Some people who’ve been living with lung disease for a long time

may have this appearance almost as a ‘normal’ state, but the sudden appearance of cyanosis

should be reported immediately as an emergency.

Breathing is a necessary function for human beings.  It supplies oxygen for a process

called cellular respiration, which is how cells manufacture the energy they need for their life

functions.  There are lots of things that can affect the rate of breathing in humans.   Exercise is

one of those things, particularly aerobic exercise.  Aerobic exercise is any exercise that

causes the person to breathe more, such as running, jogging, playing basketball, football,

running track, or playing soccer.  Another factor that can influence breathing rate is allergic

reactions to stimuli from the environment, such as pollen.  This can inflame the passageways

leading to the lungs, making them smaller, requiring more air.  Smoking is a habit that can

influence the development of lung cancer, which in turn influences the rate a person

breathes.  Nervous conditions and reactions to stimuli also influence the breathing rate, such

as the famed "fight or flight" syndrome.

Source :

WSU Health Care Sciences http://healthcaresciencesocw.wayne.edu/vs/5_1.htm

Royal College of Nursing http://rcnhca.org.uk/clinical-skills/observation/breathing/