Respiratory rate

Respiratory rate in adults

• evidence suggests that an adult with a respiratory rate of over 20 breaths/minute is probably unwell, and an adult with a respiratory rate of over 24 breaths/minute is likely to be critically ill

It has been suggested that (1):

• respiratory rate and other vital signs should be measured more frequently in patients who are unstable, or in adult patients whose respiratory rate is greater than 20 breaths/minute;
  
  
• adult general ward patients with a respiratory rate greater than 24 breaths/minute should be monitored closely and reviewed regularly
  • even if the other vital signs are normal; a patient with a respiratory rate greater than 27 breaths/minute should receive immediate medical review;
    
    
• and patients with a respiratory rate greater than 24 breaths/minute, in combination with other evidence of physiological instability (eg, hypotension or a reduced level of consciousness), should also receive immediate medical review.

Notes:

• Fieselmann and colleagues reported that a respiratory rate higher than 27 breaths/minute was the most important predictor of cardiac arrest in hospital wards (2)

Respiratory rates in children (3)

Reference:

• 1) Cretikos MA et al. Respiratory rate: the neglected vital sign. Med J Aust. 2008 Jun 2;188(11):657-9.
• 2) Fieselmann and colleagues reported that a respiratory rate higher than 27 breaths/minute was the most important predictor of cardiac arrest in hospital wards; 8:354-60.
• 3) Paediatric Assessment. University of Southampton NHS Hospitals Trust (accessed 2/1/13)