The number of respiratory movements in an adult. Determination of basic breathing indicators

As the child grows older, the ratio of respiratory rate and heart rate should approach the norm of an adult. These indicators help to calculate the intensity of physical and moral stress on the child. For adults, the norms also vary depending on the level of physical activity. Athletes have a lower heart rate than people who are not involved in sports.

What are heart rate and respiratory rate?

Counting the number of beats the heart makes per minute. Frequency breathing movements- the number of inhalations and exhalations per minute. These indicators make it possible to determine how deep and rhythmic breathing is, as well as the possibility of analyzing the performance of the chest. Characteristics of the heartbeat in different periods heights are different.

Enter your pressure

Move the sliders

Table by age for children: norms

Pulse studies have shown that in newborns it is 140 beats per minute. The pulse rate in children in the first 12 months of life decreases to 110-130, and over 12 years old - the pulse rate reaches approximately the normal adult. The norm of respiratory rate in children is important for assessing the condition of the respiratory tract, heart, circulatory system and health in general. The ratio of respiratory rate to heart rate - the respiratory-pulse ratio in infants is 1:2.5, in children under 12 months - 1:3, older - 1:4. The following table presents the norms of respiratory rate and heart rate in children by age.

Measuring heart rate and respiratory rate

How to measure your pulse:

1. Grab your wrist in the pulse detection area.
2. Start the stopwatch.
3. Count the number of heartbeats per minute.

Technique for counting breathing in children (inhale-exhale):

1. Distract the child.
2. Place your hand on your stomach or take your hand.
3. Count the number of cycles in 1 minute.
4. Evaluate the result.

To calculate the heart rate, the baby must take a stationary position. It is impossible to measure after various physical or emotional loads, because the pulse quickens. After this, it is worth determining whether the results correspond to the norm. Normally, the pulsation is rhythmic and clear. The counting technique is used for different ages. The breathing rate is measured over a minute. In children, it is better to count respiratory movements during sleep.

Deviations from the norm

In case of violation of the cardiovascular system in a child, it is necessary to contact a pediatrician.

Do not worry if the baby’s heart rate and respiratory rate differ slightly from the readings of an adult. And only if you receive data that differs significantly from the norm indicated in the table, should you be examined by a doctor to find out main reason deviations. Rapid shallow breathing is called tachypnea. An increase in heart rate is called tachycardia, a decrease is called bradycardia.

Rapid breathing

Frequent breathing is an increase in the repetition of respiratory movements, in which its rhythm does not change, and can develop due to gas exchange disorders with the accumulation of carbon dioxide in the blood and a decrease in the amount of oxygen. As a result, the range of movements during breathing becomes smaller. At times, rapid breathing worsens, which is mistaken for shortness of breath, in which the respiratory rate in children should be more than 60 inhalations and exhalations per minute.

not checked

Current version of the page so far

not checked

experienced participants and may differ significantly from

Respiratory frequency

Human breathing rate

In adults

tachypnea

1. bronchiolitis

bradypnea) may be caused by:

1. exposure to the respiratory center of toxic metabolic products accumulated in significant quantities in the blood (uremia, hepatic or diabetic coma, some acute infectious diseases and poisoning).

In children

Respiration rate in animals

see also

• Breath
• Pneumograph
• Dyspnea
• Tachypnea
• Bradypnea
• Respiratory failure
• Cheyne-Stokes breathing
• Kussmaul's Breath

Notes

1. Propaedeutics of internal diseases / V. Kh. Vasilenko. - 3rd ed., revised. and additional - M.: Medicine, 1989. - P. 92-93. - 512 s. - ( Educational literature for students of medical institutes). - 100,000 copies. - ISBN 5-225-01540-9.
2. Mazurin A.V., Vorontsov I.M. Propaedeutics of childhood diseases. - 1st ed. - M.: Medicine, 1986. - P. 118-119. - 432 s. - (Educational literature for students of medical institutes). - 100,000 copies.
3. Berkowitz's Pediatrics: A Primary Care Approach, 5th Edition Copyright. - American Academy of Pediatrics, 2014. - P. 353.

Respiratory rate- 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 number of respiratory movements is calculated by the number of movements of the chest and anterior abdominal wall. Usually during objective research First, the pulse is 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 breathing rate

In adults

A healthy adult in a state of physiological rest makes an average of 16 to 20 respiratory movements per minute, a newborn - 40-45 respiratory movements, the frequency of which gradually decreases with age. During sleep, breathing slows down to 12-14 per minute, and during physical activity, emotional arousal or after plenty of intake food - naturally increases in frequency.

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

1. narrowing of the lumen of the small bronchi due to their spasm or diffuse inflammation of their mucous membrane ( bronchiolitis), which prevent the normal flow of air into the alveoli;
2. reduction of the respiratory surface of the lungs (pneumonia - lobar or viral pneumonia, pulmonary tuberculosis, collapsed lung (atelectasis); as a result of compression of the lung - exudative pleurisy, hydrothorax, pneumothorax, mediastinal tumor; with obstruction or compression of the main bronchus by a tumor; in case of pulmonary infarction as a result of blockage of a branch of the pulmonary trunk by a thrombus or embolus; with severe emphysema of the lungs and their overflow with blood due to edema against the background of pathology of the cardiovascular system);
3. insufficient depth of breathing (shallow breathing) with sharp pain in the chest (dry pleurisy, diaphragmatitis, acute myositis, intercostal neuralgia, fracture of the ribs, or the development of metastases in them malignant tumor); at sharp increase intra-abdominal pressure and high levels of diaphragm standing (ascites, flatulence, late pregnancy) and hysteria.

Pathological decrease in breathing ( bradypnea) may be caused by:

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

In children

U healthy child the synchronous participation of both halves of the chest in the act of breathing is visually noted. To determine the degree of mobility (excursion) of the chest, use a centimeter tape to measure the circumference of the chest at the level of the nipples in front, and at the back at the angles of the shoulder blades. During examination, pay attention to the type of breathing. The number of respiratory movements is counted for a minute when the child is calm or sleeping. In newborns and children early age You can use a soft stethoscope, the bell of which is held near the nose of the child being examined. This method allows you to count the number of breathing 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.

see also

• Breath
• Pneumograph
• Dyspnea
• Tachypnea
• Bradypnea
• Respiratory failure
• Cheyne-Stokes breathing
• Kussmaul's Breath

• Doc
• 11-09-2015
• VSDshnik's Directory

Have you ever thought about how many inhalations and exhalations you take per minute? Do you know what breathing rate should be normal?

As a rule, vegetative-vascular dystonia is accompanied by various functional disorders autonomic nervous system, which in turn leads to various violations of the body’s usual vital functions. This is primarily noticeable by changes in heart rate and pressure fluctuations. But another important function of the body – breathing – is often disrupted.

Breathing disorders occur most often during panic attacks. The breathing rate increases, hyperventilation of the lungs occurs (an increase in the level of oxygen in the blood and a decrease in the level of carbon dioxide), which, in turn, manifests itself in dizziness and other bad things that are so familiar to those who have experienced PA at least once in their lives.

So the breathing rate

It is convenient to count the breathing rate by placing your hand on chest. Count for 30 seconds and multiply by two. Normal in calm state The breathing rate of an untrained person is 12-16 inhalations and exhalations per minute. You should strive to breathe at a frequency of 9-12 breaths per minute.

Vital capacity of the lungs (VC) is the amount of air that can be exhaled after the most deep breath. The value of vital capacity characterizes the strength of the respiratory muscles, the elasticity of the lung tissue and is important criterion respiratory system performance. As a rule, vital capacity is determined using a spirometer in an outpatient setting.

Breathing disorders. Hyperventilation

Respiration carries out gas exchange between external environment and alveolar air, the composition of which under normal conditions varies within a narrow range. During hyperventilation, the oxygen content increases 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 drops 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;
decline 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. When panic attack it will not come to a lethal outcome, the body will not allow itself to be killed, but you can lose consciousness. This is why it is 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.

As the child grows older, the ratio of respiratory rate and heart rate should approach the norm of an adult. These indicators help to calculate the intensity of physical and moral stress on the child. For adults, the norms also vary depending on the level of physical activity. Athletes have a lower heart rate than people who are not involved in sports.

What is heart rate and respiratory rate?

Heart rate is a count of the number of beats that the heart makes in a minute. Respiratory rate is the number of inhalations and exhalations per minute. These indicators make it possible to determine how deep and rhythmic breathing is, as well as the possibility of analyzing the performance of the chest. Heartbeat characteristics differ during different periods of growth.

To determine the value respiratory excursion chest circumference is measured at the level of the nipples during quiet breathing at the height of inhalation and exhalation (Fig. 24).

Rice. 24. Measurement of chest circumference.
Rice. 25. Thoracic (a) and abdominal (b) types of breathing.

Particular attention is paid to the nature of respiratory movements, which healthy person are accomplished due to contraction of the respiratory muscles: intercostal, diaphragmatic and partly the muscles of the abdominal wall. There are thoracic, abdominal (Fig. 25) and mixed types of breathing.

At thoracic (costal) type of breathing, which is more common in women, breathing movements are carried out by contracting the intercostal muscles. In this case, the chest expands and rises slightly during inhalation, narrows and falls slightly during exhalation.

At abdominal (diaphragmatic) type of breathing, more common in men, breathing movements are carried out primarily by the diaphragm. During inhalation, the diaphragm contracts and lowers, which increases the negative pressure in the chest cavity and the lungs fill with air. Intra-abdominal pressure increases and abdominal wall bulges out. During exhalation, the diaphragm relaxes, rises, and the abdominal wall returns to its original position.

At mixed type The intercostal muscles and diaphragm are involved in the act of breathing.

The chest type of breathing in men can be caused by inflammation of the diaphragm or peritoneum (peritonitis), increased intra-abdominal pressure (ascites, flatulence).

The abdominal type of breathing in women is observed with dry pleurisy, intercostal neuralgia, fractured ribs, which makes their movements painful.

If inhalation and/or exhalation is difficult, auxiliary respiratory muscles are involved in the act of breathing, which is not observed in healthy people. In case of chronic difficulty breathing, the sternocleidomastial muscles hypertrophy and act as dense cords. With frequent, prolonged coughing, the rectus abdominis muscles hypertrophy and thicken, especially in the upper part.

The breathing of a healthy person is rhythmic, characterized by the same frequency of inhalation and exhalation (16-20 breaths per minute). The respiratory rate is determined by the movement of the chest or abdominal wall. During physical activity, after a heavy meal, breathing becomes more frequent, and during sleep it slows down. However, increased or decreased breathing can also be caused by pathological conditions.

Increased breathing is observed, for example, with dry pleurisy (in this case, due to the pain syndrome, it is also superficial in nature), with pneumonia, atelectasis (collapsed lung) of various origins, emphysema, pneumosclerosis, causing a decrease in the respiratory surface, at high body temperature, leading to irritation of the respiratory center. Sometimes rapid breathing is caused by several reasons at once.

Decreased breathing occurs when the function of the respiratory center is inhibited, which occurs in diseases of the brain and its membranes (hemorrhage, meningitis, trauma). When exposed to the respiratory center of toxic products accumulating in the body, with renal and liver failure, diabetic coma and other diseases, rare, but noisy and deep breathing is observed ( big Kussmaul breath; rice. 26, a).

Rice. 26. Changes in the depth (a) and rhythm (b, c) of breathing compared to normal (d).

If the breathing frequency changes, its depth also changes: fast breathing is usually shallow, while slow breathing is accompanied by an increase in its depth. However, there are exceptions to this rule. For example, in the case of a sharp narrowing of the glottis or trachea (compression by a tumor, aortic aneurysm, etc.), breathing is rare and shallow.

In case of severe brain damage (tumors, hemorrhages), sometimes in diabetic coma, respiratory movements are interrupted from time to time by pauses (the patient does not breathe - apnea), lasting from several seconds to half a minute. This is the so-called Biot respiration (Fig. 26, c).

In case of severe intoxication, as well as in diseases accompanied by deep, almost always irreversible disorders cerebral circulation, observed Cheyne-Stokes breathing(Fig. 26, b). It is characterized by the fact that after a certain number of respiratory movements, patients experience prolonged apnea (from 1/4 to 1 minute), and then rare shallow breathing appears, which gradually becomes more frequent and deepens until it reaches its maximum depth. Further, breathing becomes increasingly rare and superficial until it completely stops and a new pause occurs. During apnea, the patient may lose consciousness. At this time, his pulse slows down and his pupils narrow.

Quite rare Breath of Grocco - Frugoni: while the upper and middle parts of the chest are in the inhalation phase, its lower part produces, as it were, exhalation movements. This breathing disorder occurs with severe brain damage, sometimes in an agonal state. It is the result of a violation of the coordination ability of the respiratory center and is characterized by a violation of the harmonious functioning of individual groups of respiratory muscles.

1. Create a trusting relationship with the patient.

2. Explain to the patient the need to count the pulse and obtain consent.

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

4. Place your and the patient’s hands on the chest (for thoracic breathing) or epigastric region (for abdominal breathing) of the patient, simulating a pulse examination.

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

7. Explain to the patient that his respiratory rate has been counted.

8. Wash and dry your hands.

9. Record the data in the temperature sheet.

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

5. Conducting anthropometry (measurement of height)

Execution sequence:

Place a replaceable napkin on the stadiometer platform (under the patient’s feet).

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

Place the patient on the stadiometer platform; the back of the head, spine in the area of ​​the shoulder blades, sacrum and heels of the patient should fit tightly to 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 stadiometer bar onto the patient's head and determine the height on the scale along the lower edge of the bar.

Help the patient leave the stadiometer platform and remove the napkin.

6. Conducting anthropometry (determining body weight)

Execution sequence:

If possible, establish a trusting relationship with the patient. Explain the purpose and progress of the procedure, obtain consent to carry out it.

Place a replaceable napkin on the scale platform (under the patient’s feet).

Open the shutter of the scales 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 the right side.

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

Open the shutter and determine the patient’s weight by moving the weights on the two bars of the rocker arm until the rocker arm is level with the reference mark of the medical scale.

Close the shutter.

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

Record measurement data.

7.Assessing the risk of development 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 the examination The risk of developing pressure ulcers is assessed using the Waterlow scale, which is applicable to all categories of patients. In this case, the points are summed up according to 10 parameters: 1. physique; 2. body weight, relative to height; 3. skin type; 4. gender, age; 5. special risk factors; 6. retention of urine and feces; 7. mobility; 8. appetite; 9. neurological disorders; 10. surgical interventions or injury. III. End of the procedure 1. Inform the patient(s) of the examination result 2. Make an appropriate entry about the results in the medical documentation

SEVERITY ASSESSMENTS

Execution Sequence I. Preparation for the procedure 2.. If possible, establish a trusting relationship with the patient. Explain the purpose and progress of the procedure, obtain consent to carry out it. 3.. Adjust the height of the bed. 4. Treat hands hygienically and dry. Wear gloves. II. Performing the procedure 1. Help the patient lie on his stomach or side. 2. Inspect the places where bedsores form: the sacrum, heels, ankles, shoulder blades, elbows, back of the head, greater trochanter of the femur, inner surfaces of the knee joints. 3. Assess: localization, color skin, the presence of odor 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 may be visible. 4. If necessary, use sterile tweezers and sterile gloves. III. End of the procedure 1. Inform the patient the result of the study 2. Disinfect the used material and gloves. 3. Treat hands hygienically and dry. 4. Make an appropriate entry about the results of the implementation in the medical documentation

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 number of respiratory movements is calculated by 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 breathing rate

In adults

A healthy adult in a state of physiological rest makes an average of 16 to 20 respiratory movements per minute, a newborn - 40-45 respiratory movements, the frequency of which gradually decreases with age. During sleep, breathing slows down to 12-14 per minute, and during physical activity, emotional excitement or after a heavy meal, it naturally increases.

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

1. narrowing of the lumen of the small bronchi due to their spasm or diffuse inflammation of their mucous membrane ( bronchiolitis), which prevent the normal flow of air into the alveoli;
2. reduction of the respiratory surface of the lungs (pneumonia - lobar or viral pneumonia, pulmonary tuberculosis, collapsed lung (atelectasis); as a result of compression of the lung - exudative pleurisy, hydrothorax, pneumothorax, mediastinal tumor; with obstruction or compression of the main bronchus by a tumor; with pulmonary infarction as a result blockage of a branch of the pulmonary trunk by a thrombus or embolus; with severe emphysema of the lungs and their overflow with blood due to edema against the background of pathology of the cardiovascular system);
3. insufficient depth of breathing (shallow breathing) with severe pain in the chest (dry pleurisy, diaphragmatitis, acute myositis, intercostal neuralgia, fractured ribs, or the development of metastases of a malignant tumor 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 decrease in breathing ( bradypnea) may be caused by:

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

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, use a centimeter tape to measure the circumference of the chest at the level of the nipples in front, and at the back at the angles of the shoulder blades. During examination, pay attention to the type of breathing. The number of respiratory movements is counted for a minute when the child is calm or sleeping. In newborns and young children, you can use a soft stethoscope, 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)

Respiration rate in animals

Normal 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 respiratory rate (RR) per minute? This is not particularly difficult. But certain difficulties arise with the interpretation of 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 propose to figure out what the normal respiratory rate is for children. The table will help us with this.

Features of the child's respiratory system

The first thing you've been waiting for so long future mom- the baby's first cry. It is with this sound that his first breath occurs. By the time of birth, the organs that ensure the child’s breathing are not yet fully developed, and only with the growth of the body 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 delicate, with a huge number of vessels (blood, lymphatic).

Therefore, even with minor catarrhal symptoms, the child’s nasal mucosa quickly swells, the already small lumen decreases, and as a result, breathing becomes difficult and shortness of breath develops: small children cannot yet breathe through their mouths. How younger 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. Unlike adults, their lung tissue is poorly developed, and the lungs themselves have a small volume with a huge number of blood vessels.

Rules for counting breathing rate

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

The person should be calm and in a comfortable position. If we are talking about children, especially young children, then it is better to count respiratory movements during sleep. If this is not possible, the subject should be distracted from the manipulation as much as possible. To do this, just grab your wrist (where the pulse is usually detected) and meanwhile count your breathing 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 deliberately false numbers. By placing your hand on the anterior abdominal wall (or just visually), you can easily carry out this study.

Considering that breathing has its own rhythmic cycle, it is necessary to observe the duration of its counting. Be sure to measure your respiratory rate over the course of a full minute, rather than multiplying the result obtained in just 15 seconds by four. It is recommended to carry out three counts and calculate the average.

Normal respiratory rate in children

The table shows the normal respiratory rate. Data are presented for children of different age groups.

As we 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 puberty, when the child turns 14-15 years old, the respiratory rate becomes equal to that of a healthy adult. No differences by gender are observed.

Types of breathing

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

The breast type is more typical for females. With it, inhalation/exhalation is ensured to a greater extent due to movements of the chest. The disadvantage of this type of breathing movement 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), a lack of ventilation is experienced upper sections lungs. This type of breathing movement is more common for men.

But with a mixed type of breathing, a uniform (identical) 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 ensures 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 norm of respiratory rate in children is given in more detail (table with age norms).

Rapid breathing

The first sign of respiratory damage, especially when infectious diseases, is increased breathing. In this case, there will definitely be other signs of a cold (cough, runny nose, wheezing, etc.). Quite often, when body temperature rises, the respiratory rate increases and the pulse quickens in children.

Holding your breath during sleep

Quite often, young children (especially infants) experience short-term pauses in breathing during sleep. 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 " ambulance"to prevent irreversible consequences.

Conclusion

The respiratory organs of 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 characteristics, incomplete differentiation of the structures of the central nervous system and their direct influence on the respiratory center and respiratory organs.
The younger the child, the less lung capacity he has, and therefore the more he will need to do large quantity respiratory movements (inhalation/exhalation) to provide the body with the necessary amount of oxygen.

Summing up

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

So, now you know what the normal respiratory rate is for children. The table of averages should be taken into account, but small deviations should not panic. And be sure to consult your doctor before jumping to conclusions!

Manipulation No. 40 “Calculating the number of respiratory movements (RR).”

Target: determine the main characteristics of breathing.

Indications: diseases of the respiratory system and cardiovascular system.

Contraindications: No.

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

Algorithm:

Stages	Rationale
I. Preparation for the procedure: 1. Introduce yourself kindly and respectfully to the patient. Find out how to contact him.	Establishing contact with the patient.
2. Warn the patient that a pulse examination will be performed.	The ability to control breathing is excluded.
3. Obtain the patient’s consent to perform the procedure.	The patient's rights to information are ensured.
4. Wash and dry your hands.	Ensuring infection safety
5. Ask the patient or help him to lie (sit) comfortably in bed to see top part his chest and abdomen (epigastric region).	To clarify (determine) the type and rhythm of breathing.
6. Determine the type and rhythm of breathing.	The accuracy (reliability) of NPV calculation is ensured.
II. Performing the procedure: 7. Take the patient’s hand as for examining the pulse, observe the excursion of the chest or the movements of the epigastric region of the patient’s abdomen. Count your breathing movements in 1 minute. Note: if it is not possible to observe the excursion of the chest, then place your hands (the patient’s and yours) on the chest (in women) or on the epigastric region (in men), simulating the examination of the pulse (while continuing to hold the hand on the wrist)	Determination 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 organs and cardiovascular system.
III. End of the procedure: 9. Wash and dry your hands.	Ensuring infection safety.

Manipulation No. 41 “Filling out the temperature sheet.”

Target: rules for filling out medical documentation.

Indications: registration of patient examination results.

Contraindications: No.

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

Algorithm:

Stages

Rationale

I. Preparation for manipulation. 1. Prepare a standard temperature sheet. 2. Prepare a blue or black pencil (or paste), a red pencil (or paste). II. Performing manipulation. 3. Mark the morning temperature with a dot in column “U”, the evening temperature – in column “B”. 4. Mark the upper limit (systolic) and lower limit (diastolic) blood pressure with a red pencil (or paste). 5. In column “U” mark the results of counting the pulse in the morning with a dot, and in column “B” the results of counting the pulse in the evening. 6. In the “Breathing” column, write down the count of the number of respiratory movements in 1 minute. 7. In the “Weight” column, make a note about the patient’s body weight. 8. In the “Drinking fluids” column, note the amount of fluid that entered the patient’s body. 9. In the “Daily amount of urine” column, note the amount of urine excreted by the patient per day. 10. In the “Chair” column, mark the data on defecation with a + sign. 11. In the “Bath” column, mark with a + sign about the sanitization of the patient. III. End of manipulation. 4. Connect the points of morning and evening temperatures. 5. Connect the dots of the pulse count results. 6. Mark blood pressure in the form of a column with a red pencil.

Rules for filling out medical documentation. Effectively read patient examination results. Reliability of the result. 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 heart rate results. Efficiency of filling out medical documentation.

Age norms for respiratory rate.

The ratio of respiratory rate and heart rate in healthy children in the first year of life is 3-3.5, i.e. One respiratory movement accounts for 3-3.5 heartbeats, in older children – 5 heartbeats.

Palpation.

To palpate the chest, both palms are applied symmetrically to the areas being examined. By squeezing the chest from front to back and from the sides, its resistance is determined. The younger the child is, the more pliable the chest is. Increased resistance of the chest is called rigidity.

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

Percussion.

When percussing the lungs, it is important that the child’s position is correct, ensuring the symmetry of the location of both halves of the chest. At incorrect position the percussion sound in symmetrical areas will be different, which may give rise to an erroneous assessment of the data obtained. When percussing the back, it is advisable to invite the child to cross his arms over his chest and at the same time bend slightly forward; when percussing the anterior surface of the chest, the child lowers his arms along the body. It is more convenient to percuss the anterior surface of the chest in young children when the child lies on his back. For percussion of the child's back, the child is seated, and small children must be supported by someone. If the child does not yet know how to hold his head up, 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 tapping with a bent finger (usually the middle or index finger) directly on the surface of the patient’s body. Direct percussion is more often used when examining young children.

Indirect percussion - percussion with a finger on the finger of the other hand (usually along the phalanx of the middle finger of the left hand), tightly applied with the palmar surface to the area of ​​the patient’s body surface being examined. Traditionally, percussion is done 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 shocks are too easily transmitted to distant areas.

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

When percussing healthy lungs, a clear pulmonary sound is obtained. At the height of inhalation, this sound becomes even clearer; at the peak of exhalation, it shortens somewhat. The percussion sound is not the same in different areas. 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 hue (the so-called Traube’s space).

Auscultation.

During auscultation, the position of the child is the same as during percussion. Listen to symmetrical areas of both lungs. Normally, in children under 6 months of age, they listen weakened vesicular breathing, from 6 months to 6 years – puerile(breath sounds are louder and longer during both phases of breathing).

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

Greater elasticity and thin thickness of the chest wall, increasing its vibration.

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

After 6 years of age, 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 whispers the pronunciation of words containing the sounds “sh” and “ch” (for example, “cup of tea”). Bronchophony must be examined over symmetrical areas of the lungs.

Instrumental and laboratory studies.

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

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

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

Puncture of the pleural cavity carried out for exudative pleurisy and other significant accumulations of fluid in the pleural cavity; allows for biochemical, bacteriological and serological examination of the material obtained during puncture.

X-ray method:

Radiography is the main method of x-ray diagnostics in pediatrics; a photograph is taken in a direct projection while inhaling; according to indications, a photograph is taken in a lateral projection;

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

Computed tomography (mainly cross-sections are used) provides rich information and is now increasingly replacing tomography and bronchography.

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

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

- SHOWINGS for diagnostic bronchoscopy are:

Suspicion of congenital defects;

Aspiration of a foreign body or suspicion of it;

Suspicion of chronic aspiration of food (lavage to determine the presence of fat in alveolar macrophages);

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

Carrying out a biopsy of the bronchial mucosa or transbronchial lung biopsy.

In addition to diagnostic, bronchoscopy, according to indications, is used with therapeutic purpose: sanitation of the bronchi with the introduction of antibiotics and mucolytics, drainage of the abscess.

During bronchoscopy, it is possible to perform bronchoal volar lavage (BAL) - washing the peripheral parts 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 others rare diseases lungs.

Bronchography - contrasting the bronchi to determine their structure and contours. Bronchography is not primary diagnostic study. Currently used mainly to assess the extent of bronchial lesions and the possibility surgical treatment, clarification of the form and localization of the congenital defect.

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

Study of respiratory organ functions. 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 (reduced gas exchange area, decreased extensibility of lung tissue) and combined type. Functional research allows us to differentiate types of external respiration failure, forms of ventilation failure; detect disorders not detected clinically; 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 disturbances, the degree and form of these disturbances.

Pneumochymetry gives an expiratory FVC curve, from which about 20 parameters are calculated as in absolute values, and as a percentage of the required values.

Functional tests on bronchial reactivity. Inhalation pharmacological tests carried out with β 2 -adrenergic agonists to determine hidden bronchospasm or select an adequate antispasmodic therapy. The FVD study is carried out before and 20 minutes after inhalation of 1 dose of the drug.

Allergy tests.

Skin (application, scarification), intradermal and provocative tests with allergens are used. The total IgE content and the presence of specific immunoglobulins to various allergens are determined.

Determination of blood gas composition.

Ra O and pa CO 2 are determined, as well as the pH of capillary blood. If long-term continuous monitoring of the blood gas composition is necessary, transcutaneous determination of blood oxygen saturation (S 2 O 2) is carried out in the dynamics of respiratory failure.

Software tests