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Respiration (breathing) provides a way for the
body to exchange of oxygen and carbon dioxide.
Respiration is automatically controlled by the brain. A variety of
factors can influence respirations, such as:
- Head injury (Depressed with elevation of intracranial pressure)
- Bleeding (Increased respirations with significant blood loss)
- Stress (Rapid rate and increased depth)
- Fever (Increased rate)
- Hypothermia (Slower rate and shallow breaths)
- Medications (Narcotics in large doses can depress both rate and
depth)
- Voluntary control can also influence breathing, up to a point.
To avoid voluntary changes in rate or depth, it is best to count the
respirations in such a way that the patient is not aware they are being
counted.
Start by taking the pulse of the patient:
- While you are holding the patient's wrist and looking at your watch,
use your peripheral vision to observe the chest rise and fall.
- Many experienced examiners will actually take the respiratory rate
first (even though they are holding the wrist and appearing to take
the pulse).
Ideally, the respirations are observed for a full minute and reported
as "RR=16" (meaning respiratory rate equals 16 respirations per
minute). Often, respirations are observed for only 30 seconds (and the
results doubled to give the respiratory rate per minute). If pressed for
time, respirations can be observed over 15 seconds and quadrupled to give
the RR.
The normal respiratory rate in adults is 12-20 respirations per minute.
If the patient's rate is outside those limits, it may indicate a
significant pathologic process.
Normal respirations are deep and even. The rib cage expands fully and
the abdomen rises and falls. Abnormal breathing includes deep breathing,
shallow breathing, and rapid breathing.
Abnormal respirations may be irregular, due to illness or injury. If
the patient experiences difficulty in breathing, there may be associated
noises, such as wheezing, rattling, or bubbling. The patient may be more
comfortable sitting up or leaning forward. They may appear restless and
anxious. Their skin can be pale, ashen or cyanotic. Approved for public release; Distribution is unlimited.
The listing of any non-Federal product in this CD is not an
endorsement of the product itself, but simply an acknowledgement of the source.
Operational Medicine 2001
Health Care in Military Settings
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Operational
Medicine
Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
January 1, 2001 |
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