Monitoring breathing rate is an important skill in the ICU or any medical situation where patients require respiratory support. When breathing rate changes, it’s often a sign of respiratory distress and requires immediate attention.
Monitoring breathing rate is easy with a piece of equipment called a stethoscope. A stethoscope consists of three pieces:
- The chestpiece, which is placed against the patient’s chest
- The earpieces, which are inserted into the patient’s ears
- The tubing, which connects the chestpiece to the earpieces
To monitor breathing rate, the nurse first needs to locate the patient’s pulse. Once the pulse is located, the nurse should count the number of breaths per minute by listening to the patient’s chest for 10 seconds and multiplying that number by 6. If the nurse is unable to locate the patient’s pulse, they can still monitor breathing rate by counting the number of breaths in 30 seconds and multiplying that number by 2.
There are also other ways to monitor breathing rate, such as through an inhalometer. An inhalometer is a device that can be placed in the patient’s mouth that detects the level of carbon dioxide in the air. A color-coded scale on the inhalometer indicates whether or not breathing rate is appropriate for that specific oxygen concentration.
It is important to remember that your patient may have a high breathing rate and be on a respirator , which is an artificial device that assists with breathing. The patient’s own breathing effort provides the power to move air into and out of their lungs. When using a respirator, the patient maintains the same respiratory rate as before they were placed on the machine; however, they will not be able to breathe as deeply or quickly because the respirator takes over these functions. If you are monitoring your patient’s breathing rate with a stethoscope, you need to count the number of breaths per minute rather than the number of breaths in 30 seconds.
The Importance of Monitoring Breathing Rate
Because respiratory rate is an important indicator of how well a patient is breathing, it should be monitored continuously . If respiratory rate changes, the nurse needs to act quickly in order to provide necessary treatment.
Signs of Respiratory Distress
If your patient is showing signs of respiratory distress, their breathing rate will most likely increase in an attempt to compensate for poor oxygenation. Some common signs of respiratory distress include:
• Increased respiratory rate
• Use of accessory muscles to breathe (e.g. sternocleidomastoid muscle in the neck)
• Retractions (pulling in of the skin between the ribs or below the ribcage)
• Cyanosis (bluish discoloration of the skin)
If breathing rate is increasing, it may be necessary to decrease the amount of oxygen your patient is receiving. You therefore need to be familiar with the different types of oxygen concentrations and how to adjust them. For more information on adjusting oxygen concentrations, please see our previous article entitled “How to Adjust Oxygen Levels in the ICU.”
Because respiratory rate is an important indicator of how well a patient is breathing, it should be monitored constantly. If respiratory rate changes, the nurse needs to act quickly in order to provide necessary treatment.