Respiratory rate, rhythm and pattern

Adult

12-20

10 years

15-20

Normal I:E ratio

1:2 (inspiration is half as long as expiration)

1 year

25-35 breaths/minute

Resting rates for healthy newborns

33-45 breaths/minute

Character of respiration

Normal breathing is quiet and effortless Labored breathing is evident by the use of accessory muscles of respiration wheezes and crackles are abnormal sounds produced by changes in the airways

Apnea

absence of spontaneous breathing

Depth of respiration

characterized as deeper or shallower than normal tidal volume

Paradoxical

chest wall moves in with inhalation and out with exhalation, due to chest trauma or paralysis of the diaphragm

Hypopnea

decreased rate and depth of breathing

Cheyne-Stokes (periodic)

decreasing rate and depth of breathing with periods of apnea, can occur due to CNS damage

Kussmauls

deep and fast breathing, often associated with metabolic acidosis

Tachypnea

faster than normal respiratory rate, > 20 breaths/minute in adults

Hyperpnea

increased rate and depth of breathing

Biot's

irregular breathing, breaths vary in depth and rate with periods of apnea, often associated with increased intracranial pressure or damage to the medulla

Eupnea

normal rate and depth of breathing

Respiratory rate

number of breaths per minute

Procedure

observe the patients breathing at rest for 60 seconds (an alternate method is to place your hand over the patient's upper thorax or abdomen and observe and feel movement with each respiration) Document the rate, rhythm, depth and character of respiration

What four parameters completes a respiration assessment

rate, rhythm, depth, and character

Character

refers to the effort and sound produced during breathing

Rhythm

refers to the regularity of inspirations and expirations

COPD I:E ratio

reflects a longer expiration phase 1:3 or 1:4

Bradypnea

slower than normal respiratory rate < 12 breaths/minutes in adults, may be associated with neurologic or electrolyte disturbance, infection, or high level of cardiorespiratory fitness

Depth

volume of air exchanged with each breath