| 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 |
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| Apnoea | Respiratory arrest | |||
| Depth | Shallow or deep | Hyperventilation Hypoventilation (hypercapnia) |
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| 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 |
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| Colour | Skin colour – check the skin, nail beds, lips, tongue, ears and nose |
Cyanosis – central or peripheral | Central – hypoxaemia Peripheral – perfusion abnormality |
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| Chest | Shape | Barrel chest | Emphysema | |
| Pigeon chest | Rickets | |||
| Movement | Symmetrical | Asymmetrical | Pneumothorax – air trapped in the pleura Extreme atelectasis |