• It is important to calculate the breathing rate

• This tells about the efficiency of breathing and oxygen levels in blood

• Most times, to compensate low oxygen levels, the body breathes faster.

• The respiration rate depends on various factors like infection, heart problems, fever, stress, conscious level.

• Also, newborn babies breathe faster compared to older children.

A rough estimate of respiratory rate is as below

• Infants less than 1 year- 30-40 breaths per minute

• Child 1- 5 years- 25- 35 breaths per minute

• Child 5- 12 years- 20- 25 breaths per minute

• Child over 12 years- 15- 20 breaths per minute

Variations in breathing

• Apnea- stoppage of breathing for over 20 seconds or causing slowing of heart rate

• Bradypnea- lower respiratory rate than expected for the age

• Tachypnea- Fast respiratory rate than expected for age

• Dyspnoea- difficulty in breathing

• Hyperventilation – increased depth of breathing

• Hypoventilation – decreased depth of breathing

Calculating respiratory rate

Method

Equipment required-

Watch with seconds hand

Procedure

• Explain the procedure to the parent and the child. Tell them it’s not going to hurt them.

• Make sure the child is calm before the procedure. If the child is unhappy to make sure to write a note that down next to the answer.

• Sit in front of the child. If the child is young, make them sit on their parent’s lap with their shirt unopened

• In babies, you can lie them on the bed with their chest exposed.

• With each inspiration, the chest expands and with expiration, the chest shrinks. One inspiration and one expiration together are counted as 1 breath.

• Count the breaths for one complete minute and record it. If the child is distressed then note it beside the count

Other things to access

• Depth of respiration

• Use of accessory muscles

• Is the child able to speak normally of breathless

• Asymmetry of chest movements

• Obvious abnormal sounds like grunt, wheeze, stridor.