Average respiratory rate in an adult. Determination of basic breathing indicators

1. Create a trusting relationship with the patient.

2. Explain to the patient the need to count the pulse and obtain consent.

3. Take the patient's hand as for examining the pulse.

4. Place your and the patient’s hands on the chest (for thoracic breathing) or epigastric region (for abdominal breathing) of the patient, simulating a pulse examination.

6. Assess the frequency, depth, rhythm and type of breathing movements.

7. Explain to the patient that his respiratory rate has been counted.

8. Wash and dry your hands.

9. Record the data in the temperature sheet.

Note: NPV calculation is carried out without informing the patient about the respiratory rate study.

5. Conducting anthropometry (measurement of height)

Execution sequence:

Place a replaceable napkin on the stadiometer platform (under the patient’s feet).

Raise the stadiometer bar and invite the patient to stand (without shoes!) on the stadiometer platform.

Place the patient on the stadiometer platform; the back of the head, spine in the area of the shoulder blades, sacrum and heels of the patient should fit snugly against the vertical bar of the stadiometer; the head should be in such a position that the tragus of the ear and the outer corner of the orbit are on the same horizontal line.

Lower the stadiometer bar onto the patient's head and determine the height on the scale along the lower edge of the bar.

Help the patient leave the stadiometer platform and remove the napkin.

6. Conducting anthropometry (determining body weight)

Execution sequence:

If possible, establish a trusting relationship with the patient. Explain the purpose and progress of the procedure, obtain consent to carry out it.

Place a replaceable napkin on the scale platform (under the patient’s feet).

Open the shutter of the scales and adjust them: the level of the balance beam, at which all the weights are in the “zero position”, must coincide with the control mark - the “nose” of the scales on the right side.

Close the shutter of the scale and invite the patient to stand (without shoes!) in the center of the scale platform.

Open the shutter and determine the patient’s weight by moving the weights on the two bars of the rocker arm until the rocker arm is level with the control mark of the medical scale.

Close the shutter.

Help the patient get off the scale and remove the napkin.

Record measurement data.

7.Assessing the risk of development and severity of pressure ulcers

Execution sequence:

I. Preparation for the examination

1. Introduce yourself to the patient, explain the purpose and course of the examination (if the patient is conscious). II. Performing the examination The risk of developing pressure ulcers is assessed using the Waterlow scale, which is applicable to all categories of patients. In this case, the points are summed up according to 10 parameters: 1. physique; 2. body weight, relative to height; 3. skin type; 4. gender, age; 5. special risk factors; 6. retention of urine and feces; 7. mobility; 8. appetite; 9. neurological disorders; 10. surgical interventions or injuries. III. End of the procedure 1. Inform the patient(s) of the examination result 2. Make an appropriate entry about the results in the medical documentation

SEVERITY ASSESSMENTS

Execution Sequence I. Preparation for the procedure 2.. If possible, establish a trusting relationship with the patient. Explain the purpose and progress of the procedure, obtain consent to carry out it. 3.. Adjust the height of the bed. 4. Treat hands hygienically and dry. Wear gloves. II. Performing the procedure 1. Help the patient lie on his stomach or side. 2. Inspect the places where bedsores form: the sacrum, heels, ankles, shoulder blades, elbows, back of the head, greater trochanter of the femur, inner surfaces of the knee joints. 3. Assess: location, color of the skin, presence of odor and pain, depth and size of the lesion, presence and nature of discharged fluid, swelling of the edges of the wound, presence of a cavity in which tendons and/or bone formations may be visible. 4. If necessary, use sterile tweezers and sterile gloves. III. End of the procedure 1. Inform the patient the result of the study 2. Disinfect the used material and gloves. 3. Treat hands hygienically and dry. 4. Make an appropriate entry about the results of the implementation in the medical documentation

Respiratory rate

Diaphragmatic (abdominal) type of breathing in humans

Respiratory frequency- the number of respiratory movements (inhalation-exhalation cycles) per unit of time (usually a minute). It is one of the main and oldest biomarkers.

The number of respiratory movements is calculated by the number of movements of the chest and anterior abdominal wall. Usually, during an objective study, the pulse is first determined and counted, and then the number of respiratory movements in one minute, the type of breathing (thoracic, abdominal or mixed), depth and its rhythm are determined.

Human breathing rate

In adults

A healthy adult in a state of physiological rest makes an average of 16 to 20 respiratory movements per minute, a newborn - 40-45 respiratory movements, the frequency of which gradually decreases with age. During sleep, breathing slows down to 12-14 per minute, and during physical activity, emotional excitement or after a heavy meal, it naturally increases.

Pathological increased breathing ( tachypnea) develops as a result of the presence of certain pathological conditions:

narrowing of the lumen of the small bronchi due to their spasm or diffuse inflammation of their mucous membrane ( bronchiolitis), which prevent the normal flow of air into the alveoli;
reduction of the respiratory surface of the lungs (pneumonia - lobar or viral pneumonia, pulmonary tuberculosis, collapsed lung (atelectasis); as a result of compression of the lung - exudative pleurisy, hydrothorax, pneumothorax, mediastinal tumor; with obstruction or compression of the main bronchus by a tumor; with pulmonary infarction as a result blockage of a branch of the pulmonary trunk by a thrombus or embolus; with severe emphysema of the lungs and their overflow with blood due to edema against the background of pathology of the cardiovascular system);
insufficient depth of breathing (shallow breathing) with severe pain in the chest (dry pleurisy, diaphragmatitis, acute myositis, intercostal neuralgia, fractured ribs, or the development of metastases of a malignant tumor in them); with a sharp increase in intra-abdominal pressure and a high level of diaphragm standing (ascites, flatulence, late pregnancy) and with hysteria.

Pathological decrease in breathing ( bradypnea) may be caused by:

increased intracranial pressure (brain tumor, meningitis, cerebral hemorrhage, cerebral edema);
the impact on the respiratory center of toxic metabolic products accumulated in significant quantities in the blood (uremia, hepatic or diabetic coma, some acute infectious diseases and poisoning).

In children

In a healthy child, synchronous participation in the act of breathing of both halves of the chest is visually noted. To determine the degree of mobility (excursion) of the chest, use a centimeter tape to measure the circumference of the chest at the level of the nipples in front, and at the back at the angles of the shoulder blades. During examination, pay attention to the type of breathing. The number of respiratory movements is counted for a minute when the child is calm or sleeping. In newborns and young children, you can use a soft stethoscope, the bell of which is held near the nose of the child being examined. This method allows you to count the number of respiratory movements without undressing the child. Sometimes using this method it is possible to listen to wheezing characteristic of bronchitis, bronchiolitis or pneumonia.

Newborns may experience periodic breathing - alternating regular breathing with irregular breathing. This is considered normal for this age.

Respiratory rate and basic hemodynamic parameters in children are normal Age Respiratory rate (/min) Pulse (beats/min) Systolic blood pressure (mm Hg)

Respiration rate in animals

Normal respiratory rate in children: table. Respiratory rate

One of the actions carried out during an examination by a pediatrician is counting respiratory movements. This seemingly simple indicator carries important information about the state of health in general and about the functioning of the respiratory system and the cardiovascular system in particular.

How to correctly calculate the respiratory rate (RR) per minute? This is not particularly difficult. But certain difficulties arise with the interpretation of the data. This is more true for young parents, because, having received a result from a child that is several times higher than their own, they panic. Therefore, in this article we propose to figure out what the normal respiratory rate is for children. The table will help us with this.

Features of the child's respiratory system

The first thing an expectant mother has been waiting for for so long is the baby's first cry. It is with this sound that his first breath occurs. By the time of birth, the organs that ensure the child’s breathing are not yet fully developed, and only with the growth of the body itself do they mature (both functionally and morphologically).

The nasal passages (which are the upper respiratory tract) in newborns have their own characteristics:
They are quite narrow.
Relatively short.
Their inner surface is delicate, with a huge number of vessels (blood, lymphatic).

Therefore, even with minor catarrhal symptoms, the child’s nasal mucosa quickly swells, the already small lumen decreases, and as a result, breathing becomes difficult and shortness of breath develops: small children cannot yet breathe through their mouths. The younger the child, the more dangerous the consequences can be, and the faster it is necessary to eliminate the pathological condition.

Lung tissue in young children also has its own characteristics. Unlike adults, their lung tissue is poorly developed, and the lungs themselves have a small volume with a huge number of blood vessels.

Rules for counting breathing rate

Measuring respiratory rate does not require any special skills or equipment. All you need is a stopwatch (or a watch with a second hand) and following simple rules.

The person should be calm and in a comfortable position. If we are talking about children, especially young children, then it is better to count respiratory movements during sleep. If this is not possible, the subject should be distracted from the manipulation as much as possible. To do this, just grab your wrist (where the pulse is usually detected) and meanwhile count your breathing rate. It should be noted that the pulse in children under one year of age (about 130-125 beats per minute) should not cause concern - this is the norm.

In infants, it is strongly recommended to count the respiratory rate during sleep, since crying can significantly affect the result and give deliberately false numbers. By placing your hand on the anterior abdominal wall (or just visually), you can easily carry out this study.

Considering that breathing has its own rhythmic cycle, it is necessary to observe the duration of its counting. Be sure to measure your respiratory rate over the course of a full minute, rather than multiplying the result obtained in just 15 seconds by four. It is recommended to carry out three counts and calculate the average.

Normal respiratory rate in children

The table shows the normal respiratory rate. Data are presented for children of different age groups.

As we can see from the table, the frequency of respiratory movements per minute is higher, the younger the child. Gradually, as they grow older, their number decreases, and by puberty, when the child turns 14-15 years old, the respiratory rate becomes equal to that of a healthy adult. No differences by gender are observed.

Types of breathing

There are three main types of breathing in both adults and children: chest, abdominal and mixed.

The breast type is more typical for females. With it, inhalation/exhalation is ensured to a greater extent due to movements of the chest. The disadvantage of this type of breathing movement is poor ventilation of the lower parts of the lung tissue. Whereas in the abdominal type, when the diaphragm is more involved (and the anterior abdominal wall visually moves during breathing), the upper sections of the lungs experience a lack of ventilation. This type of breathing movement is more common for men.

But with a mixed type of breathing, a uniform (identical) expansion of the chest occurs with an increase in the volume of its cavity in all four directions (upper-lower, lateral). This is the most correct type of breathing, which ensures optimal ventilation of the entire lung tissue.

Normally, the respiratory rate in a healthy adult is 16-21 per minute, in newborns - up to 60 per minute. Above, the norm of respiratory rate in children is given in more detail (table with age norms).

Rapid breathing

The first sign of damage to the respiratory system, especially in infectious diseases, is increased breathing. In this case, there will definitely be other signs of a cold (cough, runny nose, wheezing, etc.). Quite often, when body temperature rises, the respiratory rate increases and the pulse quickens in children.

Holding your breath during sleep

Quite often, young children (especially infants) experience short-term pauses in breathing during sleep. This is a physiological feature. But if you notice that such episodes become more frequent, their duration becomes longer, or other symptoms arise, such as blue lips or nasolabial triangle, loss of consciousness, you must immediately call an ambulance to prevent irreversible consequences.

Conclusion

The respiratory organs of young children have a number of features that contribute to their frequent damage and rapid decompensation of the condition. This is primarily due to their immaturity at the time of birth, certain anatomical and physiological characteristics, incomplete differentiation of the structures of the central nervous system and their direct influence on the respiratory center and respiratory organs.
The younger the child, the less lung capacity he has, and therefore he will need to make a greater number of respiratory movements (inhalation/exhalation) to provide the body with the necessary volume of oxygen.

Summing up

It should be remembered that respiratory arrhythmia is quite common in children in the first months of life. Most often, this is not a pathological condition, but only indicates age-related characteristics.

So, now you know what the normal respiratory rate is for children. The table of averages should be taken into account, but small deviations should not panic. And be sure to consult your doctor before jumping to conclusions!

Manipulation No. 40 “Calculating the number of respiratory movements (RR).”

Target: determine the main characteristics of breathing.

Indications: diseases of the respiratory system and cardiovascular system.

Contraindications: No.

Equipment: watch (stopwatch), temperature sheet or nursing observation sheet, pen and paper.

Algorithm:

Stages	Rationale
I. Preparation for the procedure: 1. Introduce yourself to the patient in a friendly and respectful manner. Find out how to contact him.	Establishing contact with the patient.
2. Warn the patient that a pulse examination will be performed.	The ability to control breathing is excluded.
3. Obtain the patient’s consent to perform the procedure.	The patient's rights to information are ensured.
4. Wash and dry your hands.	Ensuring infection safety
5. Ask or help the patient to lie (sit) comfortably in bed so that you can see the upper part of his chest and abdomen (epigastric region).	To clarify (determine) the type and rhythm of breathing.
6. Determine the type and rhythm of breathing.	The accuracy (reliability) of NPV calculation is ensured.
II. Performing the procedure: 7. Take the patient’s hand as for examining the pulse, observe the excursion of the chest or the movements of the epigastric region of the patient’s abdomen. Count your breathing movements in 1 minute. Note: if it is not possible to observe the excursion of the chest, then place your hands (the patient’s and yours) on the chest (in women) or on the epigastric region (in men), simulating a pulse examination (while continuing to hold your hand on the wrist)	Determination of NPV
8. Record the result on paper and transfer the data to the nursing observation sheet or temperature sheet.	Ensuring control over the state of the respiratory organs and cardiovascular system.
III. End of the procedure: 9. Wash and dry your hands.	Ensuring infection safety.

Manipulation No. 41 “Filling out the temperature sheet.”

Target: rules for filling out medical documentation.

Indications: registration of patient examination results.

Contraindications: No.

Equipment: temperature sheet, pens (or pencils) with red and blue paste.

Algorithm:

Stages

Rationale

I. Preparation for manipulation.

1. Prepare a standard temperature sheet.

2. Prepare a blue or black pencil (or paste), a red pencil (or paste).

II. Performing manipulation.

3. Mark the morning temperature with a dot in column “U”, the evening temperature – in column “B”.

4. Mark the upper limit (systolic) and lower limit (diastolic) blood pressure with a red pencil (or paste).

5. In column “U” mark the results of counting the pulse in the morning with a dot, and in column “B” the results of counting the pulse in the evening.

6. In the “Breathing” column, write down the count of the number of respiratory movements in 1 minute.

7. In the “Weight” column, make a note about the patient’s body weight.

8. In the “Drinking fluids” column, note the amount of fluid that entered the patient’s body.

9. In the “Daily amount of urine” column, note the amount of urine excreted by the patient per day.

10. In the “Chair” column, mark the data on defecation with a + sign.

11. In the “Bath” column, mark with a + sign about the sanitization of the patient.

III. End of manipulation.

4. Connect the points of morning and evening temperatures.

5. Connect the dots of the pulse count results.

6. Mark blood pressure in the form of a column with a red pencil.

Rules for filling out medical documentation.

Effectively read patient examination results.

Reliability of the result.

Information for the attending physician.

Ensuring continuity in nursing care.

Information for the attending physician.

Ensuring continuity in nursing care.

Information for the attending physician.

Ensuring continuity in nursing care.

Obtaining a temperature curve.

Graphic display of heart rate results.

Efficiency of filling out medical documentation.

Age norms for respiratory rate.

The ratio of respiratory rate and heart rate in healthy children in the first year of life is 3-3.5, i.e. One respiratory movement accounts for 3-3.5 heartbeats, in older children – 5 heartbeats.

Palpation.

To palpate the chest, both palms are applied symmetrically to the areas being examined. By squeezing the chest from front to back and from the sides, its resistance is determined. The younger the child is, the more pliable the chest is. Increased resistance of the chest is called rigidity.

Voice tremors– resonant vibration of the patient’s chest wall when he pronounces sounds (preferably low-frequency), felt by the hand during palpation. To assess vocal tremor, the palms are also placed symmetrically. Then the child is asked to pronounce words that cause maximum vibration of the vocal cords and resonating structures (for example, “thirty-three,” “forty-four,” etc.). In young children, vocal tremors can be examined during screaming or crying.

Percussion.

When percussing the lungs, it is important that the child’s position is correct, ensuring the symmetry of the location of both halves of the chest. If the position is incorrect, the percussion sound in symmetrical areas will be unequal, which may give rise to an erroneous assessment of the data obtained. When percussing the back, it is advisable to invite the child to cross his arms over his chest and at the same time bend slightly forward; when percussing the anterior surface of the chest, the child lowers his arms along the body. It is more convenient to percuss the anterior surface of the chest in young children when the child lies on his back. For percussion of the child's back, the child is seated, and small children must be supported by someone. If the child does not yet know how to hold his head up, he can be percussed by placing his stomach on a horizontal surface or his left hand.

There are direct and indirect percussion.

Direct percussion – percussion with tapping with a bent finger (usually the middle or index finger) directly on the surface of the patient’s body. Direct percussion is more often used when examining young children.

Indirect percussion - percussion with a finger on the finger of the other hand (usually along the phalanx of the middle finger of the left hand), tightly applied with the palmar surface to the area of the patient’s body surface being examined. Traditionally, percussion is done with the middle finger of the right hand.

Percussion in young children should be carried out with weak blows, since due to the elasticity of the chest and its small size, percussion shocks are too easily transmitted to distant areas.

Since the intercostal spaces in children are narrow (compared to adults), the pessimeter finger should be placed perpendicular to the ribs.

When percussing healthy lungs, a clear pulmonary sound is obtained. At the height of inhalation, this sound becomes even clearer, and at the peak of exhalation it shortens somewhat. The percussion sound is not the same in different areas. On the right, in the lower sections, due to the proximity of the liver, the sound is shortened; on the left, due to the proximity of the stomach, it takes on a tympanic hue (the so-called Traube space).

Auscultation.

During auscultation, the position of the child is the same as during percussion. Listen to symmetrical areas of both lungs. Normally, in children under 6 months of age, they listen weakened vesicular breathing, from 6 months to 6 years – puerile(breath sounds are louder and longer during both phases of breathing).

The structural features of the respiratory organs in children that determine the presence of puerile breathing are listed below.

Greater elasticity and thin thickness of the chest wall, increasing its vibration.

Significant development of interstitial tissue, reducing the airiness of lung tissue.

After 6 years of age, breathing in children gradually acquires the character of a vesicular, adult type.

Bronchophony – conduction of a sound wave from the bronchi to the chest, determined by auscultation. The patient whispers the pronunciation of words containing the sounds “sh” and “ch” (for example, “cup of tea”). Bronchophony must be examined over symmetrical areas of the lungs.

Instrumental and laboratory studies.

Clinical blood test allows you to clarify the degree of activity of inflammation, anemia, and the level of eosinophilia (an indirect sign of allergic inflammation).

Sputum culture from tracheal aspirate, bronchial lavage waters (throat smears reflect the microflora of only the upper respiratory tract) allows you to identify the causative agent of a respiratory disease (diagnostic titer with a semi-quantitative research method is 105 - 106), determine sensitivity to antibiotics.

Cytomorphological examination of sputum , obtained by collecting a tracheal aspirate or during bronchoalveolar lavage allows one to clarify the nature of inflammation (infectious, allergic), the degree of activity of the inflammatory process, and conduct a microbiological, biochemical and immunological study of the obtained material.

Puncture of the pleural cavity carried out for exudative pleurisy and other significant accumulations of fluid in the pleural cavity; allows for biochemical, bacteriological and serological examination of the material obtained during puncture.

X-ray method:

Radiography is the main method of x-ray diagnostics in pediatrics; a photograph is taken in a direct projection while inhaling; according to indications, a photograph is taken in a lateral projection;

Fluoroscopy - gives a large radiation dose and therefore should be carried out only according to strict indications: determining the mobility of the mediastinum during breathing (suspicion of a foreign body), assessing the movement of the domes of the diaphragm (paresis, diaphragmatic hernia) and for a number of other conditions and diseases;

Tomography – allows you to see small or merging details of lung lesions and lymph nodes; with a higher radiation dose, it is inferior in resolution to computed tomography;

Computed tomography (mainly cross-sections are used) provides rich information and is now increasingly replacing tomography and bronchography.

Bronchoscopy - a method of visual assessment of the inner surface of the trachea and bronchi, carried out with a rigid bronchoscope (under anesthesia) and a fiberoptic bronchoscope (under local anesthesia).

Bronchoscopy is an invasive method and should be performed only if there is an undeniable indication .

- SHOWINGS for diagnostic bronchoscopy are:

Suspicion of congenital defects;

Aspiration of a foreign body or suspicion of it;

Suspicion of chronic aspiration of food (lavage to determine the presence of fat in alveolar macrophages);

The need to visualize the nature of endobronchial changes in chronic diseases of the bronchi and lungs;

Carrying out a biopsy of the bronchial mucosa or transbronchial lung biopsy.

In addition to diagnostic, bronchoscopy, according to indications, is used for therapeutic purposes: sanitation of the bronchi with the administration of antibiotics and mucolytics, drainage of an abscess.

During bronchoscopy, it is possible to perform bronchoal volar lavage (BAL) - washing the peripheral parts of the bronchi with a large volume of isotonic sodium chloride solution, which provides important information in case of suspicion for alveolitis, sarcoidosis, pulmonary hemosiderosis and some other rare lung diseases.

Bronchography - contrasting the bronchi to determine their structure and contours. Bronchography is not a primary diagnostic test. Currently, it is used mainly to assess the extent of bronchial lesions and the possibility of surgical treatment, clarifying the form and localization of the congenital defect.

Pneumoscintigraphy - used to assess capillary blood flow in the pulmonary circulation.

Study of respiratory organ functions. In clinical practice, the ventilation function of the lungs is most widely used, which is methodologically more accessible. Violation of the ventilation function of the lungs can be obstructive (impaired passage of air through the bronchial tree), restrictive (reduced gas exchange area, decreased extensibility of lung tissue) and combined type. Functional research allows us to differentiate types of external respiration failure, forms of ventilation failure; detect disorders not detected clinically; evaluate the effectiveness of the treatment.

To study the ventilation function of the lungs, spirography and pneumotachometry are used.

Spirography gives an idea of ventilation disturbances, the degree and form of these disturbances.

Pneumochymetry gives an FVC exhalation curve, from which about 20 parameters are calculated both in absolute values and as a percentage of the required values.

Functional tests for bronchial reactivity. Inhalation pharmacological tests are carried out with β 2 -adrenergic agonists to determine latent bronchospasm or select adequate antispasmodic therapy. The FVD study is carried out before and 20 minutes after inhalation of 1 dose of the drug.

Allergy tests.

Skin (application, scarification), intradermal and provocative tests with allergens are used. The total IgE content and the presence of specific immunoglobulins to various allergens are determined.

Determination of blood gas composition.

Ra O and pa CO 2 are determined, as well as the pH of capillary blood. If long-term continuous monitoring of the blood gas composition is necessary, transcutaneous determination of blood oxygen saturation (S 2 O 2) is carried out over time in case of respiratory failure.

Software tests

Not only pulse, temperature and blood pressure can tell a lot about a child’s condition. The frequency of respiratory movements is also considered a very informative indicator. We will talk about how to learn how to measure it, and what frequency is considered normal, in this article.

What is it?

A biomarker such as respiratory rate has been known since ancient times. The doctors of the ancient world noticed that this indicator changes in a sick person. Today, respiratory rate (respiratory rate) does not lose its relevance in the diagnosis of a wide variety of childhood and adult diseases. One series of “inhalation-exhalation” is considered to be one movement. The number of such movements over a specific period of time is assessed - usually 1 minute.

It should be noted that NPV in children is not at all similar to that in adults. Due to their anatomical features, children breathe somewhat differently - their breathing is shallow, superficial, and the frequency of inhalation and exhalation is much higher. The oxygen needs of a growing child's body are extremely high, and the volume of the lungs and the size of the chest are small. This is why the baby needs intensive breathing.

However, there are certain norms for different ages. And an excess of the respiratory rate above these norms may indicate that the child has oxygen starvation (hypoxia). Rapid breathing accompanies a wide variety of pathologies in children.

Why measure?

The frequency of respiratory movements, coupled with the determination of heart rate and type of breathing, is of critical diagnostic importance when examining a newborn and infant. Such children cannot tell their parents what exactly is bothering them, and only by the NPV indicators can one understand that something is wrong with the baby. Most diseases that are accompanied by rapid breathing in children can be successfully treated with timely treatment and provision of proper medical care. The pediatrician, of course, will pay attention to the child’s respiratory rate at each scheduled visit to the clinic.

The rest of the time, parents are guarding children's health; they need to be able to distinguish normal breathing from abnormal breathing.

This is not difficult to do; the frequency of respiratory movements is a parameter that any mother, father or grandmother of the baby can independently determine. The main thing is to do everything correctly and correctly evaluate the results obtained.

How to measure?

If parents feel that the child is breathing too quickly, the breathing rate should be measured. It is best to do this when the child is calm, for example, in a dream. When the baby is awake, playing, experiencing something, experiencing emotions, breathing becomes more frequent, and this is quite natural.

The mother should place her hand on the baby's chest or belly. The choice of measurement location is very important because it determines the baby's breathing pattern. In infants and children under 4-5 years of age, diaphragmatic breathing predominates (the child breathes with the stomach, the peritoneum methodically rises as you inhale, and descends as you exit).

At 4 years old, a child begins to master a new way of breathing - chest breathing (when the chest rises and falls when inhaling and exhaling). By the age of 10, a child develops the type that is more characteristic of him based on gender. Boys usually have abdominal breathing, while girls have diaphragmatic breathing. Thus, determining where to place your hand is very simple - You have to take into account the age of the child.

The counting algorithm is quite simple. The “inhale-exhale” episodes are counted for 1 minute. One series of such movements is counted as one breathing movement. It is a big mistake to measure your breathing for 30 seconds and then multiply the resulting number by two. Breathing is not as rhythmic as, for example, the pulse, and therefore such a simplified method for measuring respiratory rate is not suitable. Parents will spend another minute measuring the heart rate (pulse) and it will be possible to assess the child’s condition based on age standards.

An electronic watch, a stopwatch or a clock with an arrow will be useful for measurements.

Norms

There are a lot of tables on the Internet that suggest comparing the data obtained from measuring the child’s breathing rate with the norms. It is difficult to assess the veracity of each. Pediatricians try to adhere to the data published in Berkowitz's Pediatrics: A Primary Care Approach. They are officially recognized:

Newborns. Respiration rate - 30-60 times per minute. Pulse – from 100 to 160.
Children at 6 months. Respiration rate - 25-40 times per minute. Pulse - from 90 to 120.
Children at 1 year old. Respiration rate 20-40 times per minute. Pulse - from 90 to 120.
Children at 3 years old. Respiration rate 20-30 times per minute. Pulse - from 80 to 120.
Children aged 6 years. Respiration rate 12-25 times per minute. Pulse - from 70 to 110.
Children at 10 years old. Respiration rate - 12-20 times per minute. Pulse - from 60 to 90.

Attentive parents will be able to notice any deviation from the individual child's norm. We are talking about the frequency at which a child usually breathes, because one baby has 40 inhalations and exhalations in 60 seconds, while another baby at the same age has only 25. It is clear that in the second case, an increase in frequency to 40-45 will be be considered a violation, and in the first case, in a baby with rapid breathing from birth, the same indicators will be the norm. Parents should not ignore their own observations. After all, mothers and fathers know the individual characteristics of their baby better than anyone, even a very good doctor, who sees the child for the first time.

Reasons for rejection

Exceeding the frequency of respiratory movements in medicine is called "tachypnea". This is not a disease, but just a symptom that may indicate the development of a certain pathology. We can talk about tachypnea if if the NPV differs from the norm upward by at least 20%. Frequent baby breathing has understandable physiological and psychological reasons. When children are worried, worried, in a state of stress, fear, or in a nervous situation, they very often react to stress by increasing their breathing movements.

Such tachypnea does not require correction or treatment and usually goes away on its own as the delicate children’s nervous system strengthens. If the stress is very strong, then parents can consult a neurologist and child psychologist.

With shortness of breath, shallow, shallow breathing in a child is observed only during periods of increased physical activity, at moments when the child is tired and trying to catch his breath. Shortness of breath is temporary and transient. Tachypnea is permanent. If the excess of the normal breathing rate does not disappear in the child even during sleep, this is certainly a reason to call a doctor and examine the baby for a possible disease.

What to do?

If you detect an increase in respiratory rate in newborns, it is best to call a doctor. If the baby has other symptoms - runny nose, cough, fever, breathing or exiting has become difficult, the best solution is to call an ambulance. For an older child, you can try to help yourself. A prerequisite is the absence of any additional painful signs.

To stop an attack of tachypnea, just take a paper bag, cut a small hole in it and invite the child to breathe through the bag in a playful way. This will help restore gas exchange in the cells, and breathing will stabilize.

Inhalation and exhalation should be done only through the bag; outside air should not be inhaled.

A sudden increase in breathing for no apparent reason (excitement, stress, fear) is always an alarming symptom that parents should not ignore. It is important to quickly pull yourself together, calm the baby, breathe through the bag, make sure that the baby’s skin has a normal color, has not changed, has not turned pale or has turned blue. Treatment always involves treatment of the underlying disease that caused rapid breathing.

What can't you do?

Parents should not try to give medications to a child with rapid breathing. No pills or drops at this moment can affect an individual symptom of a probable hidden disease. But it is quite possible to worsen the baby’s condition with these drugs without authorization. You should not try to give inhalation to a child with breathing problems. They are not able to help, but the burn of the respiratory tract that a baby can get from inhaling steam is a very real threat.

It is important for parents to learn to distinguish tachypnea from ordinary shortness of breath.

To learn what the child’s breathing rate is considered correct, see the following video.

What is the normal breathing rate for a person?

As a rule, vegetative-vascular dystonia is accompanied by various functional disorders of the autonomic nervous system, which in turn leads to various disturbances in the usual vital functions of the body. This is primarily noticeable by changes in heart rate and pressure fluctuations. But another important function of the body – breathing – is often disrupted.

Breathing disorders occur most often during panic attacks. The breathing rate increases, hyperventilation of the lungs occurs (an increase in the level of oxygen in the blood and a decrease in the level of carbon dioxide), which, in turn, manifests itself in dizziness and other bad things that are so familiar to those who have experienced PA at least once in their lives.

So the breathing rate

It is convenient to count your breathing rate by placing your hand on your chest. Count for 30 seconds and multiply by two. Normally, in a calm state, the breathing rate of an untrained person is 12-16 inhalations and exhalations per minute. You should strive to breathe at a frequency of 9-12 breaths per minute.
Vital capacity (VC) is the amount of air that can be exhaled after the deepest breath has been taken. The value of vital capacity characterizes the strength of the respiratory muscles, the elasticity of the lung tissue and is an important criterion for the performance of the respiratory organs. As a rule, vital capacity is determined using a spirometer in an outpatient setting.

Breathing disorders. Hyperventilation

Respiration carries out gas exchange between the external environment and the alveolar air, the composition of which under normal conditions varies within a narrow range. During hyperventilation, the oxygen content increases slightly (by 40-50% of the original), but with further hyperventilation (about a minute or more), the CO2 content in the alveoli decreases significantly, as a result of which the level of carbon dioxide in the blood drops below normal (this condition is called hypocapnia). Hypocapnia in the lungs during deep breathing shifts the pH to the alkaline side, which changes the activity of enzymes and vitamins. This change in the activity of metabolic regulators disrupts the normal course of metabolic processes and leads to cell death. To maintain the constancy of CO2 in the lungs, the following defense mechanisms arose during evolution:
spasms of the bronchi and blood vessels;
increased production of cholesterol in the liver as a biological insulator that seals cell membranes in the lungs and blood vessels;
decreased blood pressure (hypotension), which reduces the removal of CO2 from the body.

But spasms of the bronchi and blood vessels reduce the flow of oxygen to the cells of the brain, heart, kidneys and other organs. A decrease in CO2 in the blood increases the connection between oxygen and hemoglobin and makes it difficult for oxygen to enter cells (Verigo-Bohr effect). A decrease in oxygen flow into tissues causes oxygen starvation of tissues - hypoxia. Hypoxia, in turn, leads first to loss of consciousness and then to death of brain tissue.
The ending of the quote is somewhat gloomy, but it’s a fact and there’s no getting around it. In the event of a panic attack, it will not lead to death, the body will not allow itself to be killed, but you can lose consciousness. This is why it is important to learn how to control your breathing during a panic attack. Breathing into a paper bag helps a lot with hyperventilation: the CO2 level does not drop so quickly, you feel less dizzy, and this makes it possible to calm down and regulate your breathing.

In a healthy person, the respiratory rate ranges from 16 to 20 per minute. During quiet breathing, a person inhales and exhales on average 500 cm3 of air in one breathing movement.

Respiration rate depends on age, gender, body position. Increased breathing occurs during physical activity and nervous excitement. Breathing decreases during sleep, in a horizontal position of a person.

The calculation of the respiratory rate should be carried out unnoticed by the patient. To do this, take the patient's hand

as if for the purpose of determining the pulse and unnoticed by the patient, the respiratory rate is calculated. The results of the respiratory rate calculation must be noted daily on the temperature sheet in the form of blue dots, which, when connected, form a respiratory rate curve. Normal breathing is rhythmic and of medium depth.

There are three physiological types of breathing.

1. Thoracic type - breathing is carried out mainly due to the contraction of intercostal

muscles; noticeable expansion of the chest when inhaling. The chest type of breathing is characteristic mainly of women.

2. Abdominal type - respiratory movements are performed mainly due to the diaphragm;

There is a noticeable forward displacement of the abdominal wall when inhaling. The abdominal type of breathing is observed more often in men.

3. Mixed breathing is more often observed in older people.

Dyspnea, or shortness of breath (Greek dys - difficulty, rpoe - breathing), is a violation of the frequency, rhythm and depth of breathing or an increase in the work of the respiratory muscles, usually manifested by subjective sensations of lack of air or difficulty breathing. The patient feels short of air. It should be remembered that shortness of breath can be either pulmonary, cardiac, neurogenic or other origin. Depending on the respiratory rate, there are two types of shortness of breath.

Tachypnea - rapid shallow breathing (over 20 per minute). Tachypnea most

often observed with lung damage (for example, pneumonia), fever, blood diseases (for example, anemia). With hysteria, the respiratory rate can reach 60-80 per minute; such breathing is called “the breath of a hunted animal.”

Bradypnea - pathological decrease in breathing (less than 16 per minute); he is being watched

for diseases of the brain and its membranes (cerebral hemorrhage, brain tumor), prolonged and severe hypoxia (for example, due to heart failure). The accumulation of acidic metabolic products in the blood (acidosis) in diabetes mellitus and diabetic coma also depresses the respiratory center.

Depending on the violation of the breathing phase, the following types of shortness of breath are distinguished.

Inspiratory dyspnea - difficulty breathing.

Expiratory shortness of breath - difficulty exhaling.

Mixed shortness of breath - both phases of breathing are difficult.

Depending on the change in breathing rhythm, the following main forms are distinguished:

shortness of breath (so-called “periodic breathing”).

Cheyne-Stokes breathing is breathing in which, after a respiratory pause,

at first, shallow, rare breathing, which gradually increases in depth and frequency, becomes very noisy, then gradually decreases and ends with a pause, during which the patient may be disoriented or lose consciousness. The pause can last from several to 30 seconds.

Biota Breathing - rhythmic periods of deep breathing movements alternate

at approximately equal intervals with long breathing pauses. The pause can also last from several to 30 seconds.

Kussmaul breathing - deep, rare breathing with a deep noisy inhalation and intense exhalation; it is observed in deep coma.

Factors leading to increased heart rate, can cause an increase in the depth and frequency of breathing. This is physical activity, increased body temperature, strong emotional experience, pain, blood loss, etc. The rhythm is determined by the intervals between breaths. Normally, breathing movements are rhythmic. In pathological processes, breathing is irregular. Types of breathing: chest, abdominal (diaphragmatic) and mixed.

Observation of breathing should be carried out unnoticed by the patient, since he can arbitrarily change the frequency, depth, and rhythm of breathing. You can tell the patient that you are examining their pulse.

Determination of frequency, depth, rhythm of breathing (in a hospital setting). Equipment: watch or stopwatch, temperature sheet, hand, paper.

Sequence of actions:

1. Warn the patient that a pulse examination will be performed (do not inform the patient that the respiratory rate will be examined).

2. Wash your hands.

3. Ask the patient to sit (lie down) comfortably so that you can see the upper part of his chest and (or) abdomen.

4. Take the patient’s hand as for examining the pulse, but observe the excursion of his chest and count the respiratory movements for 30 s. then multiply the result by 2.

5. If you cannot observe the excursion of the chest, then place your hands (yours and the patient’s) on the chest (in women) or the epigastric region (in men), simulating the examination of the pulse (while continuing to hold your hand on the wrist).

Counting respiratory movements is a standard point in examining a child by a pediatrician. Despite the apparent simplicity and obviousness of this manipulation, NPV can provide important information about how healthy the baby is and whether everything is okay with him. Since the number of breaths per minute in children is much higher than in adults, a special table of respiratory rate norms has been developed for them.

The respiratory system of babies and its features

The first opening of the lungs in a newborn occurs immediately after the baby is born. By this time, the child’s respiratory system is not yet fully developed and has a number of features. Thus, babies have narrow and short nasal passages, which cannot always cope with full breathing. The respiratory system tailored for breastfeeding does not allow children to breathe through their mouths, so they may develop shortness of breath and blockage of the nasal passages.

A small child is not yet able to independently clear the nasal passages by blowing his nose, so for normal breathing he especially needs the care and attention of an adult.

Interesting: During sleep, babies may hold their breath during the transition from REM sleep to slow sleep and back, this is completely normal.

How to calculate NPV correctly

This is the simplest procedure that can be done at home. It only requires a stopwatch and the baby at rest, otherwise the data will be unreliable. The ideal time to calculate NPV would be sleep, since crying or restlessness of the child can distort the results of the study.

You can measure the baby's respiratory rate visually, by movements of the chest, or by placing your palm on it. An older child can be held by the wrist (under the base of the thumb) and, watching the pulse, count the number of inhalations and exhalations.

Normal respiratory rate in children

The table shows the average values of normal respiratory rate in children from 0 to 12 years old. In the future, the norm of the child’s respiratory rate coincides with the norm of an adult.

The table clearly shows that respiratory rate decreases with age, while the breathing rate does not depend on a person’s gender. This is due to the fact that with age the respiratory system gradually strengthens, changing at each stage of development.

What does the NPV data say?

If, after correctly measuring the respiratory rate, you find that the child’s breathing is rapid or difficult, you should immediately consult a doctor. This may indicate both disorders in the respiratory system and the presence of an infectious disease.

At the same time, increased breathing during physical activity, increased emotionality, or a child’s enthusiasm for some activity is completely normal and does not require contacting a specialist.