the 100% directionless thread

I just count the numbers from the ETCO2 monitor. Otherwise it's only an issue when it's too fast or too slow.
 
If the patient is on EKG, then they're also on Resp... otherwise I watch the patient for a few seconds and if they seem to be breathing about once every 5 seconds, I put down 12. If once every 3, I put 20. Is it exact? No. Is it close enough? Yes. If the patient looks like they're in distress somehow, then I'll count the actual rate. It's usually not far off my guesstimated rate.
 
18 is my go to number if the patient isn't having any respiratory issues.
 
MonkeyArrow said:
Do the respiration thing all the time. Am taking vitals near the patient, go back to the computer to chart, and see the little respiration box. Look at the RN, she tells me 16. And onto the next thing. RR rate isn't significant in light of SpO2 and the patients general appearance presentation (in distress or not).
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We had an interesting discussion in chat recently about SpO2, CO2 and respiratory rate. If a patient is breathing room air, SpO2 is a pretty good indicator of their ventilation... But if they're on supplemental oxygen, it's possible to maintain good O2 sats while hypoventilating, not blowing off enough CO2 and becoming dangerously acidotic.

One instance where this could be relevant is in a heroin OD or a post-surgery patient coming out of anesthesia. Patient who has some spontaneous respiratory drive - they're breathing slow, you narcan them and throw on a cannula: "Their O2 sat is 99, good to go" you say to yourself, but that isn't the whole story.
 
I never really understood the anti odd number stigma. Sure I get that when you count the number of beats/breaths in 15 sec and multiply by 4 (or count to 30 and multiply by 2) it'll be an even number, but say you actually count the whole minute (say 'cuz its irregular or otherwise abnormal) or especially in todays age of electronic monitors why some still view writing an odd number as a BAD thing that must be avoided or else
 
Jim37F said:
I never really understood the anti odd number stigma. Sure I get that when you count the number of beats/breaths in 15 sec and multiply by 4 (or count to 30 and multiply by 2) it'll be an even number, but say you actually count the whole minute (say 'cuz its irregular or otherwise abnormal) or especially in todays age of electronic monitors why some still view writing an odd number as a BAD thing that must be avoided or else
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I don't view it as bad. I just don't like odd numbers in general. I have issues...
 
Gurby said:
But if they're on supplemental oxygen, it's possible to maintain good O2 sats while hypoventilating, not blowing off enough CO2 and becoming dangerously acidotic.

One instance where this could be relevant is in a heroin OD or a post-surgery patient coming out of anesthesia. Patient who has some spontaneous respiratory drive - they're breathing slow, you narcan them and throw on a cannula: "Their O2 sat is 99, good to go" you say to yourself, but that isn't the whole story.
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This is exactly true. Patients have died in the ED after being given haldol & ativan and having a NRB slapped on their face and being ignored for an hour and a half because telemetry showed they had an Sp02 of 100%.
 
Remi said:
This is exactly true. Patients have died in the ED after being given haldol & ativan and having a NRB slapped on their face and being ignored for an hour and a half because telemetry showed they had an Sp02 of 100%.
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Honestly scary to see the misuse of SpO2 like this outside of the prehospital world.
 
Red Cross, you guys are great, and I probably should schedule a donation sometime, BUT, PLEASE stop calling 5 times a day every friggen day, first the house phone then my cell immediately after that.....quite frankly its a bit of a turn off and makes me NOT want to do anything with y'all (geeze I feel like I'm texting a clingy new gf haha)
 
Jim37F said:
Red Cross, you guys are great, and I probably should schedule a donation sometime, BUT, PLEASE stop calling 5 times a day every friggen day, first the house phone then my cell immediately after that.....quite frankly its a bit of a turn off and makes me NOT want to do anything with y'all (geeze I feel like I'm texting a clingy new gf haha)
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I had to put their number into the ignore category. Two days after a donation they called again.
 
Rhonda said:
Just made one of the biggest rookie mistakes. I didn't pee when I had the chance. Now we are 40 miles from town on a code off of a really bumpy dirt road. Lesson re learned
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I HATE when that happens. lol
 
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