# Ventilation Rates- CONFUSED



## ethomas4 (May 20, 2010)

3 QUestions about ventilation rate in Adult apneic patient...are ventilations deliverd at a rate of 8-10 breaths/ min or 10/12?

1 My book says deliver 10-12breaths/min, however the online supplemental learning resource for the EXACT same book says it should be 8-10. I am a bit confused and have my NREMT test this weekend..in my EMT class it was 10-12 breaths/min

2 Also, if the patient is intubated/has an advanced airways is the rate of ventialtions 8-10 breaths/ min?

 3 Do these numbers change if patient is only apneic or apneic AND pulseless??

Thank you


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## mycrofft (May 20, 2010)

*Ask your instructor for the proper answer.*

In real world, rule of thumb is watch the pt chest (once you know air is going in the lungs and not in the stomach or out a hole somewhere), do not let them absolutely deflate (but do not fail to let the pt exhale somewhat), then reinflate promptly without overinflation. Watch for effectiveness, watch for respiratory effort, and feel for pulse or listen for heartbeat. Apnea can become pulselessness in a hurry. See the pt's color.

Big beefers and skinny minnies, pigeon chests and injured chests, they all have different elasticity.


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## Aidey (May 20, 2010)

ethomas4 said:


> 2 Also, if the patient is intubated/has an advanced airways is the rate of ventialtions 8-10 breaths/ min?
> 
> 3 Do these numbers change if patient is only apneic or apneic AND pulseless??
> 
> Thank you



2. Yes. If there is an advanced airway in place the rate stays the same. If there is an advanced airway in place and CPR in progress you ventilate continuously, not on the 30:2 ratio(or other appropriate ratio). 

3. Kind of. If the patient is apneic and pulseless and there is no advanced airway CPR would be in progress, and thus your rate of ventilation would depend on the ratio of CPR. Once there is an advanced airway in place ventilation is continuous.


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## EMSLaw (May 20, 2010)

Not to confuse you more, but I seem to recall that the normal respiratory rate for an adult is somewhere in the range of 12-20 breaths per minute.  It's my understanding that the NREMT considers anything between 10-20 breaths in a minute to be adequate when bagging a patient.  Basically, one breath every 3-5 seconds.  

Aidley is right about the others.  Once the patient is tubed, you continue ventilations continously while CPR is in progress, at the same rate of one breath every 3-5 seconds.  If CPR is in progress without an advanced airway, you're doing the 30:2 thing.  Which works out to something like 5-6 breaths a minute, but as we are all by now well aware, the breaths are less important than hard, fast, effective chest compressions.


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## dudemanguy (May 20, 2010)

Sounds like you had the same text book I had....where numbers like this can vary from chapter to chapter. I remember studying for my finals and making sure I memorized normal vital sign ranges for each age group, which would obviously be important in answering scenario questions. Simple enough right. Problem is the chaper on vital signs had one set of ranges, the chapter on pediatric patients were slightly different for a couple age groups, a chapter on airway might differ yet again. I finally concluded some things in EMS are more of an art than an exact science.


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## medichopeful (May 20, 2010)

ethomas4 said:


> 3 QUestions about ventilation rate in Adult apneic patient...are ventilations deliverd at a rate of 8-10 breaths/ min or 10/12?
> 
> 1 My book says deliver 10-12breaths/min, however the online supplemental learning resource for the EXACT same book says it should be 8-10. I am a bit confused and have my NREMT test this weekend..in my EMT class it was 10-12 breaths/min
> 
> ...



Did you use the Brady book by any chance?


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## Pneumothorax (May 20, 2010)

mycrofft said:


> In real world, rule of thumb is watch the pt chest (once you know air is going in the lungs and not in the stomach or out a hole somewhere), do not let them absolutely deflate (but do not fail to let the pt exhale somewhat), then reinflate promptly without overinflation. Watch for effectiveness, watch for respiratory effort, and feel for pulse or listen for heartbeat. Apnea can become pulselessness in a hurry. See the pt's color.
> 
> Big beefers and skinny minnies, pigeon chests and injured chests, they all have different elasticity.



i find it so annoying that we are taught one thing in school and for testing purposes it is the be all end all, but in real life things are much more complex.  but i guess its hard to accommodate all the variables of life into a test eh?


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## medichopeful (May 20, 2010)

ethomas4 said:


> 3 QUestions about ventilation rate in Adult apneic patient...are ventilations deliverd at a rate of 8-10 breaths/ min or 10/12?
> 
> 1 My book says deliver 10-12breaths/min, however the online supplemental learning resource for the EXACT same book says it should be 8-10. I am a bit confused and have my NREMT test this weekend..in my EMT class it was 10-12 breaths/min
> 
> ...



According to the AHA, these are the "textbook" answers:
1) You should deliver 1 breath every 5-6 seconds.  This comes out to 10-12 breaths/minute
2) If there is an advanced airway in place, for an adult it drops down to 1 breath every 6-8 seconds, without pausing for compressions.
3) Yes, they do.  If the patient is apneic w/ a pulse, then you are doing the numbers above.  However, if they are pulseless AND apneic, then you are doing cycles of 30:2 (for an adult), unless there is an advanced airway in place, then you are doing the 1 breath every 6-8 seconds.  I hope this helps.


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## Focallength (May 27, 2010)

In a nut shell, 10-12 when bagging a patient, the 8-10 is for a patient that has been tubed. I know alot of people that got confused with that because the question would say something like "you are assisting ventilations to a patient with a advanced airway" or something to the affect, and it would give you options and the 2 best are 10-12 or 8-10. the 8-10 is for any patient with an advanced airway. Its not so much as a trick question as much as it is knowing proper procedures for different situations.


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## ethomas4 (May 27, 2010)

Thanks for all the replies...and sorry for question #3..that was me being retarded 


anyway I Passed NREMT!!


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