Routine Measurement of Respiratory Rate

The routine repeated measurement of the respiratory rate is of clinical value in less than 5% of patients in a hospital, and furthermore physicians themselves rarely show an interest in such measurements. As a result of such indifference, nurses have been increasingly casual in their measurement of respiratory rates, and, in many cases, though a figure is recorded, no actual measurement was made. In one carefully controlled experiment measurements of respiratory rate were carried out in 58 patients within minutes of the routine ward measurements. The ward records showed 57 of these patients as having a rate between 18 and 22 per minute; 40 having a rate of exactly 20. The real range was from 11 to 33 per minute, only five patients showing a rate of 20. If recording the respiratory rate is important, the character of the breathing is of equal importance. Nursing personnel should recognize abnormal breathing patterns and bring these abnormal findings to the attention of the physician. It is suggested that routine recording of respiratory rates be limited to those cases or on those hospital wards where the physician specifically orders such measurements. This not only would improve the accuracy of the measurements and clinical records but also would save millions of hours of personnel time each year.