This article is written for students in year two of their BNURSE progarm of a major university. It describes the different types of respirations seen in pathological situations. Knowing the breathing pattern is helpful in being able to deal with it. Also it is easier to communicate the patient’s condition (acuity) to other members of the treatment team if you can describe the patient’s breathing accurately. The graphic representations are of the author. This article is not suitable reading for individuals who are not comfortable with terminal stages of life.
This article is written for Nurses, by a Lecturer in Health Sciences. It describes the different types of respirations nurses see frequently in the Hospital situations. Respirations indicate the severity of illness and are often helpful in assessing the patients overall condition. This article will be useful for care givers and medical students as well. The diagrammatic representations are copyrighted materials of this author.
In this article the following are discussed and explained – Iron lungs, normal respiration, Bradypnea, Tachypnea, Kussmaul’s respirations, Biot’s respirations, Cheyne-stokes Respirations, apnea and respiratory arrest.
The ordinary word for respiration is breathing. Respiration is the movement of air from the exterior of the patient to the interior. Strictly speaking, this is called external respiration. Internal respiration is the metabolic process at cell level, equated with (combustion) because during this process oxygen is combined with carbohydrates to produce energy. Heat is a by-product of metabolism. During metabolism, energy is created for use by muscles for functions of life.
For optimal external respiration to occur, the patient must be placed in the optimal position for him/her. Patient positions are discussed in another article. The hyperlink is attached. Shergill , diagrams of the different positions are also available at that site.
Normal inspiration occurs because muscle activity, maily contraction, changes the volume of the intrathoracic cavity. When the volume increased, the pressure is decreased. The decreased pressure on the interior forces the air from the exterior to enter the lungs until the two pressures become roughly equal. At this point the stretch receptors stop the lung from expanding any further, in fact, the intercostal muscles relax. By recoil the pressure on the interior increses and expel air to the exterior. Normal tidal volumes and other respiratory parameters are found here. Iron lungs worked be decreasing the pressure on the outside, thereby lifting the rib cage to decrease the intra thoracid pressure.
Picture 1. Patient inside iron lungs for external respiration (victim of polio).
Iron lungs are now redundant. They have been replaced by high tech ventilators.
In the hospital environment, Nurses are the eyes and ears of the treatment team because they are with the patient all the time and usually know the patient best. As the patients condition changes so will his respiration. A brief description of the different types of respiration is given below. The normal respiratory rate is 12 to 18 breaths per minute. During each breath cycle the air moves in and out of the lungs quietly. The rib case rises and falls. There will also be some movement of the diaphragm, and abdominal region.