1. Vital Signs
Respiration

2. Respiration
Process of bringing oxygen into the body and expelling carbon dioxide from the body
The process is controlled by the brain and regulated by the changing carbon dioxide levels in the blood stream
At rest less CO2 in blood stream, slower respiration rate

3. Respiration Rate & Exercise
At rest
Muscles require less oxygen
Less CO2 in blood
Slower respiration rate
During exercise
Muscles require more oxygen
Metabolism increases; increases CO2 in blood
Faster respiration rate

4. Changes to Respiration Rate
Excitement
Increases in epinephrine (adrenaline)
Pain
Fever
Trauma

5. Changes to Respiration Rate
Drugs
Diseases
Nicotine
Marijuana
Cocaine
Heroin
Asthma
Emphysema
Diabetes-Ketoacidosis

6. Changes to Respiration Rate
If breathing patterns are altered and the body is deprived of oxygen serious damage can occur to the vital organs
Vital Organs- essential to the bodies survival
Brain
Heart
Kidneys
Liver
Lungs

7. Changes to Respiration Rate
The absence of respiration indicates a blocked airway or death
Cardiopulmonary Resuscitation (CPR) will be performed

8. Respiration Rate Each respiration is divided into two phases
Phase 1: inhalation; breathing in.
Phase 2: exhalation; breathing out
Ranges:
Age 15 and over breaths per minute
Well trained athlete: 6 to 8 breaths per minute
Why do you think trained athletes respiration rates are so much lower?

9. Respiration Patterns Abdominal
Primarily use abdominal muscles- chest is mostly still
Apnea
Cessation of breathing, may be temporary or permanent
Sleep apnea

10. Respiration Patterns Bradypnea Abnormal decrease in respirations
Less than 12 respirations per minute
Cheyne-Stokes
Very irregular pattern
Intermittent periods of apnea seconds, followed by periods of fast and slow breathing
Occur as someone is close to death

11. Respiration Patterns Decreased Very little air movement in the lungs
Dyspnea
Difficult or painful breathing, shortness of breath
Common with emphysema
Hyperpnea or Tachypnea
Abnormal increase in respirations
More than 20 respirations per minute
Hyperventilation

12. Respiration Patterns Kussmaul’s breathing Deep gasping respirations
Patient feels and urge to breathe
Associated with diabetic ketoacidosis and kidney failure
Labored breathing
Difficult breathing
Uses shoulder, neck and abdominal muscles

13. Measuring respiration Rate
When a person focuses on breathing, the rate of respiration is often altered
May increase or decrease rate of respiration
Try to hide the fact that respirations are being counted
Tell patient that you are taking their pulse, but really measure respiration rate

14. respiration Rate-Volume
Volume of air exchanged can be determined by placing one hand on patient’s chest and feeling chest rise and fall

15. respiration Rate-Volume
Describing volume
Deep
Prolonged inspiration possible indication of:
Upper airway obstruction
Prolonged expiration possible indication of:
Chronic obstructive pulmonary disease (COPD)
Asthma
Bronchitis
Emphysema

16. Measuring respiration Rate
Describing volume
Shallow
Shock may be occurring
Irregular
Gasping (think sleep apnea, kussmauls or cheyne-stokes)
May indicate cardiac issues

17. Measuring respiration Rate
Describing volume
Noisy
Obstruction of the air way
Swallowed foreign object
Laryngitis – voice box or vocal cords irritated from overuse
Anaphylaxis – Medical emergency
Occurs in people with severe allergies
When exposed to allergen causes a combination of a rash, abdominal pain, difficulty breathing and shock

18. Signs of Oxygen Deprivation
If a patient is having difficulty breathing have the individual sit up and lean forward
Signs of oxygen deprivation
Mental confusion
Restlessness
A person experiencing signs/symptoms of oxygen deprivation must be seen immediately- could lead to shock

19. Medications Anti-histamines Bronchodilators Decongestants
Used to treat allergic conditions
Bronchodilators
Used to assist in opening narrowed airways
Used to treat Asthma, COPD and emphysema
Albuterol – used to treat asthma
Decongestants
Used to assist in loosening secretions from the airway

20. Chart Noting
Include:
Respiration rate, respiration pattern and volume of respiration
If additional medical attention was advised

21. Chart Noting- Answers given at the end
Respiration rate: 14 breaths per minute, pattern: normal, volume: normal

22. Chart Noting- Answers given at the end
Respiration rate: 10 breaths per minute, pattern: Cheyne-Stokes, volume: irregular and noisy, EMS activated

23. Chart Noting- Answers given at the end
Respiration rate: 22 breaths per minute, pattern: Kussmaul, volume: shallow, EMS activated

24. Chart Noting- Answers given at the end
Asthmatic patient; Respiration rate: 9 breaths per minute, pattern: decreased and labored, volume: shallow, patient administered own inhaler, parents contacted

25. Chart Noting
Respiration rate: 14 breaths per minute, pattern: normal, volume: normal
RR was measured at 14 breaths per minute with a normal pattern and normal volume. Signature with title

26. Chart Noting
Respiration rate: 10 breaths per minute, pattern: Cheyne-Stokes, volume: irregular and noisy, EMS activated
RR was measured at 10 breaths per minute with a Cheyne-Stokes pattern and irregular and noisy volume. 911 was called and pt was transported to the hospital. Signature with title

27. Chart Noting
Respiration rate: 22 breaths per minute, pattern: Kussmaul, volume: shallow, EMS activated
RR was measured at 22 breaths per minute with a Kussmaul pattern and shallow volume was called and pt was transported to the hospital. Signature with title

28. Chart Noting
Asthmatic patient; Respiration rate: 9 breaths per minute, pattern: decreased and labored, volume: shallow, patient administered own inhaler, parents contacted
RR was measured at 9 breaths per minute with a decreased and labored pattern and shallow volume. Pt administered their own inhaler. Parents were contacted and advised to seek additional medical help if signs and symptoms persist. Signature with title