Today we're going to discuss the respiratory rate. Which is a vital sign, that tells us about the respiratory system. So you learned a lot this week from Dr. Scanga about how the lungs work, how the respir, respiratory system operates to deliver oxygen to the body. But how do we assess respiration rate and the quality of the patient's breathing and oxygenation, when they come into the doctor's office or when we're taking care of them at the hospital. The answer is, we measure their respiration rate it's very simple to measure respiration rate I'm going to demonstrate very briefly here on Jane. Jane, I'm assuming you're going to let me you're going to volunteer. >> Yes. >> Yes, okay so I have a watch here with a second hand. And I've making, made sure that Jane is comfortable and relaxed are you comfortable and relaxed? >> Yes, I am. >> Great, and I'm going to watch, Jane breathe. I may even want to put my hand on her shoulder, or my hand on her back, to feel her body breathing. And count the number of times, that she takes a breath for 60 seconds. Now before you came in today I asked you all to measure your respiration rate. And would you be so kind as to share with us Dr. Scanga, what were your respirations? >> 12 breaths per minute. And Lauren? >> 20 breaths per minute. >> Jane? >> 18 breaths per minute. >> And my respirations were 22 breaths per minute. Now, does that mean that one of us has a problem is Dr. Scanga breathing too slowly, I'm breathing too quickly? What do you think? You're shaking your head no, Jane. >> No. >> No. So there's a range, there a large range of healthy, normal respiration rates. We like to think of the normal healthy rate as being somewhere between 15 and 20 respirations or breaths per minute. Now there's a lot of variation that could still be normal for a patient. But just like with temperature, we're thinking not about the, the specific number or the, or the actual measurement we have that day, we're thinking about how that respiration rate compare to what's normal for that patient. There are circumstances that might cause someone's respirations to be elevated, or depressed or reduced. Can, can either of you think of a situation that would cause a more rapid or elevated respiration rate? >> After exercise. >> Right, aft, after exercise. >> And during. >> And during exercise, yes. What do you think, Jane? >> If you're anxious. >> Excellent, so that's why we want to make sure when you're, when you're measuring a person's respiration, rate that they're relaxed that they have rushed into your office, that they're comfortable. And you may want to explain to them, why you're staring at them and staring at your watch, right? So they don't get nervous. How about a depressed or decreased respiration rate? If you're sleeping. >> Right, if you're sleeping. Lauren, do you have any ideas? >> Hypothermia. >> Hypothermia, excellent. >> [LAUGH] >> You also want to keep in mind that certain medications in drugs, can cause both elevated respirations and decreased respirations, okay. Now oftentimes when you are in a doctor's office, or if you're taking care of someone at home, you're not going to necessarily measure the respiration rate. You're going to look at the quality of their breathing. Is the patient having difficulty breathing? Are they breathing with ease? Are they coughing? Do they feel short of breath? So if I can again demonstrate on you, Jane. You just take a nice, normal breath in and out through your nose. Good, now I want you to take a really deep breath, fill up your lungs. So if I had a patient who was breathing like this, gimme another one. I would notice that she was using her accessory muscles to breathe. She was doing more work of breathing, and that's something to be concerned about clinically. Okay, once we get into this, this simulation lab we'll learn more about what clinicians are listening for and doing when they are, listening to your lungs with a stethoscope. We also explore the, the quality of the breath sounds that you're making, which can be diagnostic for certain disorders like asthma or pneumonia. Dr. Scanga, is there anything that you wanted to add? >> Well, I think, was sitting here thinking as you were talking a little bit about the fact that we have discussed that inhaling is an active process and exhaling is an, a quiet exhale is a passive process. I was thinking about some of the patients that you see in your clinical setting, Amanda. Thinking about patients who are using their accessory muscles of breathing just to inhale that means exhaling is also more of a physical challenge for them too, usually, and so for those patients, I just want to point out that, that labored breathing, requires that every breath they take involves more work for them. And so we can sit here breathing quietly, and we don't really notice that we're expending energy to breathe. People that have compromised respiration and have to work harder with each breath, really do have an energy cost associated with that breathing. It's especially noteworthy in neonate and pediatric patients. >> Yes and it, it's also very distressing and uncomfortable to have to, to have, as you said, labored breathing and, have to work to breath so, it's, it's something that help patients with. >> Mm-hm. >> Also to, to prevent that distress. >> Mm-hm. >> And to treat the underlying cause of their labored breathing. >> Mm-hm.
