The average respiratory rate in an adult. Determination of the main indicators of breathing

1. Create a trusting relationship with the patient.

2. Explain to the patient the need to count the pulse, get consent.

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

4. Put your and the patient's hands on the chest (with chest type of breathing) or the epigastric region (with abdominal type of breathing) of the patient, simulating a pulse test.

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

7. Explain to the patient that he has counted the frequency of respiratory movements.

8. Wash and dry your hands.

9. Record the data in the temperature sheet.

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

5. Anthropometry (height measurement)

Execution sequence:

Place a changeable napkin on the platform of the stadiometer (under the patient's feet).

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

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

Help the patient get off the platform of the stadiometer and remove the napkin.

6. Carrying out anthropometry (determination of body weight)

Execution sequence:

Establish a relationship of trust with the patient as much as possible. Explain the purpose and course of the procedure, obtain consent to conduct.

Place a changeable napkin on the scale platform (under the patient's feet).

Open the scales shutter 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 their right side.

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

Open the shutter and determine the weight of the patient by moving the weights on the two beams of the rocker until the rocker is flush with the reference mark of the medical scales.

Close shutter.

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

Record measurement data.

7. Assessment of the risk of developing 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 a survey The assessment of the risk of developing pressure ulcers is carried out according to the Waterlow scale, which is applicable to all categories of patients. In this case, the summation of points is carried out according to 10 parameters: 1. physique; 2. body weight, relative to height; 3. skin type; 4. gender, age; 5. specific risk factors; 6. retention of urine and feces; 7. mobility; 8. appetite; 9. neurological disorders; 10. surgery or injury. III. End of procedure 1. Inform the patient(s) of the result of the examination 2. Make an appropriate record of the results of the performance in the medical records

SEVERITY ESTIMATES

Execution sequence I. Preparation for the procedure 2.. Establish a relationship of trust with the patient, if possible. Explain the purpose and course of the procedure, obtain consent to conduct. 3. Adjust the height of the bed. 4. Treat hands in a hygienic way, dry. Put on gloves. II. Performing the Procedure 1. Help the patient lie on their stomach or side. 2. Examine the places of formation of bedsores: sacrum, heels, ankles, shoulder blades, elbows, occiput, greater trochanter of the femur, inner surfaces of the knee joints. 3. Evaluate: localization, color of the skin, the presence of smell and pain, the depth and size of the lesion, the presence and nature of the discharged fluid, swelling of the edges of the wound, the presence of a cavity in which tendons and / or bone formations can be seen. 4. If necessary, use sterile forceps and sterile gloves. III. End of the procedure 1. Inform the patient of the result of the study 2. Disinfect the used material and gloves. 3. Treat hands in a hygienic way, dry. 4. Make an appropriate record of the results of the implementation in the medical records

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 calculation of the number of respiratory movements is carried out according to 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 respiratory rate

In adults

A healthy adult in a state of physiological rest performs an average of 16 to 20 respiratory movements per minute, a newborn - 40-45 respiratory movements, the frequency of which gradually decreases with age. In sleep, breathing slows down to 12-14 per minute, and during physical exertion, emotional arousal or after a heavy meal, it naturally becomes more frequent.

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

narrowing of the lumen of small bronchi during 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, lung collapse (atelectasis); as a result of lung compression - exudative pleurisy, hydrothorax, pneumothorax, mediastinal tumor; with obstruction or compression of the main bronchus by a tumor; with lung infarction as a result blockage by a thrombus or embolus of a branch of the pulmonary trunk; with pronounced emphysema of the lung and their overflow with blood during edema against the background of the pathology of the cardiovascular system);
insufficient depth of breathing (shallow breathing) with sharp pains in the chest (dry pleurisy, diaphragmatitis, acute myositis, intercostal neuralgia, fracture of the ribs, or the development of malignant tumor metastases 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 slowing of breathing ( bradypnea) can be called:

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

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 with a centimeter tape, measure the circumference of the chest at the level of the nipples in front, and behind at the angles of the shoulder blades. On examination, pay attention to the type of breathing. The count of the number of respiratory movements is carried out for a minute when the child is calm or sleeping. In a newborn and young children, a soft stethoscope can be used, 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 in this way it is possible to listen to wheezing characteristic of bronchitis, bronchiolitis or pneumonia.

In newborns, periodic breathing can be noted - 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)

Respiratory rate in animals

Norm of respiratory rate in children: table. Respiratory rate

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

How to correctly calculate the frequency of respiratory movements (RR) per minute? This is not particularly difficult. However, there are some difficulties in interpreting 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 still propose to figure out what is the norm of NPV in children. The table will help us with this.

Features of the child's respiratory system

The first thing that the expectant mother has been waiting for so long is the first cry of the baby. It is with this sound that his first breath occurs. By the time of birth, the organs that ensure the respiration of the child are not yet fully developed, and only with the growth of the organism 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 tender, with a huge number of vessels (blood, lymph).

Therefore, even with minor catarrhal phenomena, the nasal mucosa in a child quickly swells, and the small lumen decreases, as a result, breathing becomes difficult, shortness of breath develops: young 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. They, unlike adults, have poorly developed lung tissue, and the lungs themselves have a small volume with a huge number of blood vessels.

Rules for counting the respiratory rate

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

The person should be in a calm state and in a comfortable position. If we are talking about children, especially at an early age, then the calculation of respiratory movements is best done in a dream. If this is not possible, the subject should be distracted from the manipulation as much as possible. To do this, it is enough to take hold of the wrist (where the pulse is usually determined) and in the meantime count the respiratory rate. It should be noted that the pulse in children under one year old (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 obviously false numbers. By placing your hand on the anterior abdominal wall (or just visually), you can easily conduct this study.

Given that breathing has its own rhythmic cycle, it is necessary to observe the duration of its calculation. Be sure to measure the respiratory rate for a full minute, and not multiply the result obtained in just 15 seconds by four. It is recommended to carry out three counts and calculate the average value.

Norm of respiratory rate in children

The table shows the norms of the frequency of respiratory movements. Data are presented for children of different age groups.

As you 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 the pubertal period, when the child is 14-15 years old, the respiratory rate becomes equal to this indicator in an adult healthy person. No gender differences are observed.

Breath types

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

The chest type is more characteristic of the female representative. With it, inhalation / exhalation is provided to a greater extent due to the movements of the chest. The disadvantage of this type of respiratory movements 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 respiratory movements is more typical for men.

But with a mixed type of breathing, a uniform (equal) 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 provides 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 rate 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 rapid breathing. In this case, there will certainly be other signs of a cold (cough, runny nose, wheezing, etc.). Quite often, with an increase in body temperature, the respiratory rate increases and the pulse quickens in children.

Holding your breath during sleep

Quite often, in young children (especially infants) in a dream, there are short-term respiratory arrests in duration. This is a physiological feature. But if you notice that such episodes become more frequent, their duration becomes longer, or other symptoms occur, such as blue lips or nasolabial triangle, loss of consciousness, you should immediately call an ambulance to prevent irreversible consequences.

Conclusion

The respiratory organs in 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 features, incomplete differentiation of the structures of the central nervous system and their direct effect on the respiratory center and respiratory organs.
The younger the child, the less lung capacity he has, so, therefore, he will need to make more respiratory movements (inhalation / exhalation) in order to provide the body with the necessary amount of oxygen.

Summing up

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

So, now you know what the rate of NPV in children is. The table of averages should be taken into account, but small deviations should not be panicked. And be sure to check with your doctor before jumping to conclusions!

Manipulation No. 40 "Counting the number of respiratory movements (respiratory movements)".

Target: determine the main characteristics of breathing.

Indications: diseases of the respiratory system, and the cardiovascular system.

Contraindications: No.

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

Algorithm:

Stages	Rationale
I. Preparation for the procedure: 1. Kindly and respectfully introduce yourself to the patient. Find out how to contact him.	Establishing contact with the patient.
2. Warn the patient that a pulse test will be performed.	The ability to control breathing is excluded.
3. Obtain the consent of the patient for the procedure.	The patient's right to information is ensured.
4. Wash and dry your hands.	Ensuring infectious safety
5. Ask the patient or help him to lie down (sit down) comfortably in bed so that he 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.	EFFECT: accuracy (reliability) of NPV calculation is provided.
II. Execution of the procedure: 7. Take the patient by the hand as for the study of the pulse, observe the excursion of the chest or the movements of the epigastric region of the patient's abdomen. Count respiratory movements for 1 minute. Note: if it is not possible to observe the excursion of the chest, then put your hands (the patient and yours) on the chest (in women) or on the epigastric region (in men), imitating the study of the pulse (continuing to hold the hand by the wrist)	Definition 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 system and the cardiovascular system.
III. End of procedure: 9. Wash and dry your hands.	Ensuring infectious safety.

Manipulation No. 41 "Filling in the temperature sheet."

Target: rules for filling out medical documentation.

Indications: registration of the results of the examination of the patient.

Contraindications: No.

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

Algorithm:

Stages

Rationale

I. Preparing for manipulation.

1. Prepare a standard temperature sheet.

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

II. Performing a manipulation.

3. Mark the morning temperature with a dot in column "Y", the evening temperature - in column "B".

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

5. In column "U" mark the results of counting the pulse in the morning, and in column "B" the results of counting the pulse in the evening.

6. In the "Respiration" column, write down the count of the number of respiratory movements in 1 minute.

7. In the column "Weight" make a note about the data of the patient's body weight.

8. In the column "Liquid drunk" note the amount of liquid that has entered the patient's body.

9. In the column "Daily amount of urine" note the amount of urine excreted by the patient per day.

10. In the "Stool" column, mark with a sign + data on defecation.

11. In the column "Bath" mark with a + sign about the sanitization of the patient.

III. end of manipulation.

4. Connect the points of morning and evening temperature.

5. Connect the points of the results of counting the pulse.

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

Rules for filling out medical documentation.

Efficient reading of 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 pulse results.

Efficiency of completing medical records.

Age norms of respiratory rate.

The ratio of NPV and HR in healthy children in the first year of life is 3-3.5, i.e. 3-3.5 heartbeats are accounted for one respiratory movement, in older children - 5 heartbeats.

Palpation.

For palpation of the chest, both palms are symmetrically applied to the examined areas. By squeezing the chest from front to back and from the sides, its resistance is determined. The younger the child, the more pliable the chest. With increased resistance of the chest, they speak of rigidity.

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

Percussion.

When percussion of the lungs, it is important that the position of the child 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 uneven, which may give rise to an erroneous assessment of the data obtained. When percussion of the back, it is advisable to offer the child to cross his arms over his chest and at the same time bend forward slightly; with percussion of the anterior surface of the chest, the child lowers his arms along the body. The anterior surface of the chest in young children is more convenient to percuss when the child lies on his back. For percussion, the child’s back is planted, and someone should support small children. If the child does not yet know how to hold his head, he can be percussed by placing his stomach on a horizontal surface or his left hand.

Distinguish between direct and indirect percussion.

Direct percussion - percussion with a bent finger (usually the middle or index finger) percussion directly on the surface of the patient's body. Direct percussion is more often used in the examination of young children.

Indirect percussion - percussion with a finger on the finger of the other hand (usually on the phalanx of the middle finger of the left hand), tightly attached with the palmar surface to the area of the patient's body surface being studied. Traditionally, percussion strikes are applied 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 tremors are too easily transmitted to distant areas.

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

With percussion of healthy lungs, a clear pulmonary sound is obtained. At the height of inhalation, this sound becomes even clearer, at the peak of exhalation it is somewhat shortened. In different areas, the percussion sound is not the same. 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 shade (the so-called Traube space).

Auscultation.

During auscultation, the position of the child is the same as during percussion. Listen to symmetrical sections of both lungs. Normally, children up to 6 months listen weakened vesicular breathing, from 6 months to 6 years - puerile(breath sounds are louder and more prolonged during both phases of breathing).

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

Great elasticity and small thickness of the chest wall, increasing its vibration.

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

After 6 years, 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 whispered pronunciation of words containing the sounds "sh" and "h" (eg, "cup of tea"). Bronchophony must be examined over symmetrical areas of the lungs.

Instrumental and laboratory research.

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

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

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

Puncture of the pleural cavity carried out with exudative pleurisy and other significant accumulations of fluid in the pleural cavity; allows to carry out biochemical, bacteriological and serological research of the material received at a puncture.

X-ray method:

Radiography is the main method of X-ray diagnostics in pediatrics; a picture is taken in direct projection on inspiration; according to indications, a picture is taken in a lateral projection;

Fluoroscopy - gives a large radiation exposure and therefore should be carried out only according to strict indications: elucidation of mediastinal mobility during breathing (suspicion of a foreign body), assessment of the movement of the domes of the diaphragm (paresis, diaphragmatic hernia) and in 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 load, it is inferior in resolution to computed tomography;

Computed tomography (mostly transverse sections are used) provides a wealth of information and is now increasingly replacing tomography and bronchography.

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

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

- R e p o n i n g for diagnostic bronchoscopy are:

Suspicion of congenital defects;

Aspiration of a foreign body or suspicion of it;

Suspicion of chronic aspiration of food (lavage with determination of the presence of fat in alveolar macrophages);

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

Conducting 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 introduction of antibiotics and mucolytics, drainage of an abscess.

During bronchoscopy, it is possible to carry out bronchoa l l o l ar n o l o l a v a and (BAL) - washing the peripheral sections 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 of the bronchi in order to determine their structure, contours. Bronchography is not a primary diagnostic study. Currently, it is mainly used to assess the prevalence of bronchial lesions and the possibility of surgical treatment, to clarify the form and localization of congenital malformation.

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

Study of the functions of the respiratory system. 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 (decrease in the area of gas exchange, decrease extensibility of lung tissue) and combinatory type. Functional research allows to differentiate types of insufficiency of external respiration, forms of ventilation insufficiency; detect disorders that are not clinically detectable; 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 disorders, the degree and form of these disorders.

Pneumotachymetry gives the FVC exhalation curve, according to which about 20 parameters are calculated both in absolute values and in% of the due values.

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

Allergic tests.

Apply skin (application, scarifying), intradermal and provocative tests with allergens. Determine the total content of IgE and the presence of specific immunoglobulins to various allergens.

Determination of the gas composition of the blood.

Determine p and O and p and CO 2, as well as the pH of capillary blood. If necessary, long-term continuous monitoring of the gas composition of the blood is carried out percutaneous determination of blood oxygen saturation (S 2 O 2) in dynamics with respiratory failure.

Software Tests

Not only the pulse, temperature and blood pressure can tell a lot about the condition of the child. 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 the norm, in this article.

What it is?

Such a biomarker as the frequency of respiratory movements has been known since ancient times. The healers of the ancient world noticed that this indicator changes in a sick person. Today, NPV (respiratory frequency) does not lose its relevance in the diagnosis of a wide variety of childhood and adult diseases. For one movement it is considered to be one series of "inhale-exhale". The number of such movements for a specific period of time is estimated - usually it is 1 minute.

It should be noted that The NPV in children is not at all similar to that in adults. Children, due to anatomical features, breathe a little differently - their breathing is shallow, superficial, the frequency of inhalations and exhalations 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. That is why the baby needs intensive breathing.

However, there are certain norms for different ages. And the excess of the respiratory rate in excess of 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 the heart rate and the type of breathing, is of paramount diagnostic importance when examining a newborn and infant. Such children cannot tell their parents what exactly worries them, and only by the NPV indicators can one understand that something is wrong with the baby. Most of the diseases that are accompanied by rapid breathing in children are 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 on guard for children's health, it is they who need to be able to distinguish between normal breathing and abnormal breathing.

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

How to measure?

If parents think that the child is breathing too fast, the respiratory 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.

Mom should put her hand on the chest or stomach of the child. The choice of measurement site is very important, as it determines the type of breathing of the baby. In infants and children up to 4-5 years, diaphragmatic breathing prevails (the child breathes with the stomach, the peritoneum methodically rises on inspiration, and falls on exit).

At the age of 4, the development of a new way for the baby to breathe begins - chest breathing (when, when inhaling and exhaling, the chest rises and falls). By the age of 10, a child develops the type that is more characteristic of him by gender. Boys usually have abdominal breathing, while girls usually have diaphragmatic breathing. Thus, determining the place where to put your hand is very simple - must be based on the age of the child.

The calculation algorithm is quite simple. Within 1 minute count the episodes of "inhale-exhale". One series of such movements counts as one breath. It is a big mistake to measure your breath for 30 seconds, then to multiply the resulting number by two. Breathing is not as rhythmic as, for example, the pulse, and therefore such a simplified method for measuring the respiratory rate is not suitable. Parents will spend another minute measuring the heart rate (pulse) and it will be possible to assess the condition of the child, starting from age norms.

For measurement, an electronic clock, stopwatch or clock with an arrow is useful.

Norms

There are a lot of tables on the Internet, according to which it is proposed to compare the data obtained as a result of measuring the child's respiratory rate with the norms. It is difficult to assess the veracity of each. Pediatricians try to stick to the data published in Berkowitz's Pediatrics: A Primary Care Approach. They are officially recognized:

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

Attentive parents will be able to notice any deviation from the individual children's norm. We are talking about the frequency at which the child usually breathes, because one baby has 40 breaths in 60 seconds, and 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, in crumbs with frequent 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 any, even a very good doctor, who sees a 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. You can talk about tachypnea if if the NPV differs from the norm upwards by at least 20%. There are quite understandable physiological and psychological reasons for frequent children's breathing. When children worry, worry, are in a state of stress, fright, in a nervous situation, they very often react to stress by increasing their respiratory movements.

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

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

What to do?

When detecting an increase in respiratory rate in newborns, it is best to call a doctor. If the baby has other symptoms - a runny nose, cough, fever, inhalation or exit has become difficult, the best solution is to call an ambulance. An older child can try to help on their own. A prerequisite is the absence of any additional painful symptoms.

To stop an attack of tachypnea, it is enough to 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, air from the outside cannot be inhaled.

Sudden increased 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 child's skin has a normal color, has not changed, has not turned pale and cyanosis has not appeared. Treatment always involves the treatment of the underlying disease that caused rapid breathing.

What can not be done?

Parents should not try to give medication to a child with rapid breathing. No pills and drops at this moment can affect a single symptom of a possible latent disease. But it is quite possible to worsen the condition of the baby without permission with these drugs. Do not try to make a child with respiratory disorders inhalation. They are not able to help, but the burn of the respiratory tract, which the baby can get when inhaling steam, is a very real threat.

It is important for parents to learn to distinguish tachypnea from the most common shortness of breath.

For information on what breathing rate in a child 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 violations of the body's usual vital functions. First of all, this is noticeable by a change in the pulse rate and pressure fluctuations. But another important function of the body is often disturbed - breathing.

Most of all, respiratory disorders are manifested during panic attacks. The respiratory rate increases, hyperventilation of the lungs sets in (an excess of oxygen in the blood and a decrease in carbon dioxide), which, in turn, is manifested by dizziness and other bad things that are so familiar to those who have experienced PA at least once in their lives.

So the respiratory rate

It is convenient to count the respiratory rate by placing a hand on the chest. Count for 30 seconds and multiply by two. Normally, in a calm state, the respiratory rate in an untrained person is 12-16 breaths and exhalations per minute. 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 is taken. The VC value 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, VC is determined using a spirometer in an outpatient setting.

Respiratory disorders. Hyperventilation

Respiration carries out gas exchange between the external environment and alveolar air, the composition of which under normal conditions varies in a narrow range. With hyperventilation, the oxygen content rises 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 falls below normal (this condition is called hypocapnia). Hypocapnia in the lungs with 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 a constant CO2 in the lungs, the following defense mechanisms have evolved in the course of evolution:
spasms of the bronchi and blood vessels;
an increase in the production of cholesterol in the liver as a biological insulator that seals cell membranes in the lungs and blood vessels;
lowering 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 bond between oxygen and hemoglobin and makes it difficult for oxygen to enter cells (the Verigo-Bohr effect). A decrease in oxygen supply to tissues causes oxygen starvation of tissues - hypoxia. Hypoxia, in turn, leads first to loss of consciousness, and then to the death of brain tissue.
The ending of the quote is somewhat gloomy, but it is a fact and there is no getting around it. In the event of a panic attack, it will not come to a lethal outcome, the body will not allow itself to be killed, but you can lose consciousness. That's why it's 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 fall as quickly, the head is less dizzy and this makes it possible to calm down and put your breathing in order.

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

Respiratory rate depends on age, gender, body position. Increased breathing occurs during physical exertion, nervous excitement. Breathing is reduced in a dream, 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 hand of the patient

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

There are three physiological types of respiration.

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

muscles; noticeable expansion of the chest during inspiration. The chest type of breathing is characteristic mainly for women.

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

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

3. Mixed type of breathing is more often observed in the elderly.

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 breath. It should be remembered that shortness of breath can be of both pulmonary and cardiac, neurogenic and other origins. 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). In hysteria, the respiratory rate can reach 60-80 per minute; such breathing is called "the breath of a hunted beast."

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

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

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

Inspiratory dyspnea - difficulty breathing.

Expiratory dyspnea - difficult to exhale.

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

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

shortness of breath (so-called "periodic breathing").

Cheyne-Stokes respiration is a breath in which, after a respiratory pause,

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.

Biot breathing - rhythmic periods of deep breathing movements alternate

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

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

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

Breathing monitoring should be carried out imperceptibly for the patient, as he can arbitrarily change the frequency, depth, rhythm of breathing. You can tell the patient that you are examining his pulse.

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

Sequencing:

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

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 by the hand as for the study of 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 it is not possible to observe the excursion of the chest, then put your hands (your own and the patient's) on the chest (in women) or the epigastric region (in men), simulating the study of the pulse (continuing to hold your hand by the wrist).

Counting respiratory movements is a standard item for 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 in order with him. Since the number of breaths per minute in children is much greater than in adults, a special table of the rate of respiratory rate 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 respiratory system of the child is not yet fully developed and has a number of features. So, babies have narrow and short nasal passages that cannot always cope with full breathing. A breastfeeding-tailored respiratory system prevents babies from breathing through their mouths, so they may develop shortness of breath and blocked nasal passages.

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

Interesting: during sleep, babies can hold their breath during the transition from REM to slow sleep and vice versa, this is absolutely normal.

How to correctly calculate NPV

This is the simplest procedure that can be carried out at home. It will only require a stopwatch and the baby at rest, otherwise the data will be unreliable. Sleep is the ideal time to calculate RPV, as crying or restlessness of the child can skew the results of the study.

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

Norm of respiratory rate in children

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

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

What do NPV data say?

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

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