General Respiratory Assessment

 

Focus Observe Normal adult values Abnormalities Indications
Respiration Quality, rate Rate: 12–18 per
minute
Bradypnoea <10
breaths per minute
Head injury
Narcotic overdose
Tachypnoea Following exertion
Pneumonia
Diabetic ketoacidosis
Pyrexia – rate of
breathing increases by
7 breaths per minute
for every 10°C rise in
the patient’s
temperature
Apnoea Respiratory arrest
Depth Shallow or deep Hyperventilation
Hypoventilation
(hypercapnia)
Rhythm Regular rhythm Cluster breathing –
normal breathing
interspersed with
apnoeic pauses
Neurological disorders
Cheyne–Stokes –
the rate changes
with increasing
periods of apnoea
End of life
Effort Unable to complete a sentence
Use of accessory
muscles
Muscle retraction –intercostal and
suprasternal muscles
Nasal flaring
Pneumonia
Airway inflammation/
obstruction
Emphysema
Trauma
Colour Skin colour –
check the
skin, nail beds, lips, tongue, ears and nose
Cyanosis – central or peripheral Central – hypoxaemia
Peripheral – perfusion
abnormality
Chest Shape Barrel chest Emphysema
Pigeon chest Rickets
Movement Symmetrical Asymmetrical Pneumothorax – air
trapped in the pleura
Extreme atelectasis

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