I was looking after a gentleman the other week who had ‘difficulty in breathing’ who clearly did not!
That in itself is not too much of a big story to blog about, however the conversation that ensued afterwards with a couple of crew mates outside of the Accident and Emergency unit made me smile and laugh, so in my book, that does get posted.
As we were chatting, I was asked by Steve what the patients resps were?
16, I replied.
“Of course they were 16, arent they always”
The discussion then took off as we gave each other patient scenarios and then both said exactly the same resp rates out loud. It appears that we all have an automatic immediate resp rate response for certain classes of patients. Now, this isnt something that I am particularly proud of, but I am pretty sure that 99% of us out there will do it. Or am I completely wrong?
- Normal adult with no shortness of breath = 16 resps per min
- Adult with mild exacerbation of COPD = 26-28 resps per min
- Adult with severe exacerbation of COPD = 38-42 resps per min
- Adult Hyperventilating = 45-50 resps per min
- Adult heroin overdose (not yet in resp arrest)= 6-8 resps per min
The list can go on and on, and of course will include children of all ages too. The point being that we have grown to be able to take a look at a patient and gauge their respiratory rate down to within a few resps the vast majority of the time, havent we?
I took it upon myself over the next couple of shifts to try my theory. I guessed the resp rate and wrote it on my patient report form, then took 30 seconds and counted the resps without the patient being aware of what I was doing.
Guess what?, I didnt have to change my PRF once. I may have been 1 resp out a couple of times, but that was it.
Of course there are always going to be those times where you take a resp rate accurately and count them out, but the vast majority of the time we seem to just take a look at the patient and go
What made me laugh though was when I was talking to another colleague Tom, about this potential blog post. We laughed again as we went through the list and the fact that we were coming out with the same resp rates for all of the imagined patients, but when I suggested that sometimes just to mix it up, I would put a 17 down, his answer was
“Oh god no, you cant put odd numbers down, thats just wrong!”
So come on, own up and give me your automatic resp rates for certain classes of patient. Lets see if there is an international unwritten resp rate rule!!