HEALTH SCIENCES PRESENTATION

Adequate vs InadequateRespiration

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A good respiratory rate falls within an average range of 12 to 20 per minute for adults and for adolescents between the ages of 12-15 years. Elderly adults have a resting respiratory rate that rant from 20-24 per minute. The averages can still range for anyone. It's concerning if the RR is less than 8/minute and higher than 24/minute in adult patient. The situation can still have an affect. During assessment it's important to check rate, rhythm, quality and depth of the breathing. Rate is the number of respirations in a minute. an inhale plus and exhale equals one respiration. Then you have rhythm by looking at the pattern of respirations. Are they regular or irregular? Last is quality of breathing which is assessed by tidal volume. Tidal volume will help determine if breathing is adequate or inadequate.

• Look by inspecting the chest wall rise and fall. Looking for good retractions of the intercostal muscles and checking for adequate expansion. What's does the general appearance look like? If the patient is not responsive, then I would put my ear by the mouth or nose and look at the chest.
• Listen to the breathing and to the patients response. Are they only saying a few words and have to take a moment to to catch their breath? Then the patient does not have adequate breathing. If the breathing is clear, bilateral and sounds clear. It's not fast or too slow, then that's adequate.
• Feel the volume of air during exhalation. Is there good tidal volume and is it equal? Then it is adequate. If the volume is inadequate, then ventilation is needed.
• Auscultate by placing a stethoscope below the middle of the clavicle by 2 inches and on the midclavicular line. Listen to both sides for equal breathing and is there full inhalation and exhalation. If the breath sounds are diminished then that would indicate inadequate breathing.

Adequate and inadequate breathing is assessed by:

Adequate and Inadequate Breathing

Other signs include:

1. RR is inadequate
2. Tachypnea is excessively rapid
3. Bradypnea is very slow

• Stroke
• Heart attack (Myocardial infarction)
• OD
• Poisoning
• Suffocation
• Traumatic injuries to the head, spine, chest, or abdomen
• Airway blockage
• Apnea (stops breathing)

Common causes of inadequate breathing occurs with repiratory failure or respiratory arrest. This could be caused by:

Inadequate Breathing

Adequate ventilation is performed when the device is fitted properly and monitored at all times. Ventilating can't be too fast or the patient will not have adequate exhalation. This can cause gastric distention. The delivery of each ventilation should be over 1 second. A patients color will improve. The patients heart rate will return to normal. If delivery is to fast or too slow, then that will cause inadequate ventilation. If the device is not properly fitted due to a poor mask seal or the airway is obstucted can cause inadequate ventilation. Some other signs of inadequate ventilation can be seen by skin color (pale, cyanotic, or gray). If the chest doesn't rise and fall with ventilation is inadequate.

Adequate vs Inadequate Ventilations

Mistovich, Joseph J., and Keith J. Karren. Prehospital Emergency Care. 12th ed., Pearson, 2024. Pages 266-275

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