Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN.
Department of Medicine, Stanford University Medical Center, Stanford, CA.
Chest. 2013 Jun;143(6):1740-1744. doi: 10.1378/chest.12-1837.
Vital signs are critical data in the care of hospitalized patients, but the accuracy with which respiratory rates are recorded in this population remains uncertain. We used a novel flash mob research approach to evaluate the accuracy of recorded respiratory rates in inpatients.
This was a single-day, resident-led, prospective observational study of recorded vs directly observed vital signs in nonventilated patients not in the ICU on internal medicine teaching services at six large tertiary-care centers across the United States.
Among the 368 inpatients included, the median respiratory rate was 16 breaths/min for the directly observed values and 18 breaths/min for the recorded values, with a median difference of 2 breaths/min (P < .001). Respiratory rates of 18 or 20 breaths/min accounted for 71.8% (95% CI, 67.1%-76.4%) of the recorded values compared with 13.0% (95% CI, 9.5%-16.5%) of the directly observed measurements. For individual patients, there was less agreement between the recorded and the directly observed respiratory rate compared with pulse rate.
Among hospitalized patients across the United States, recorded respiratory rates are higher than directly observed measurements and are significantly more likely to be 18 or 20 breaths/min.
生命体征是住院患者护理中的关键数据，但在该人群中记录呼吸频率的准确性仍不确定。我们使用一种新颖的快闪族研究方法来评估住院患者记录呼吸频率的准确性。
这是一项为期一天、由住院医师领导的、在美国六家大型三级保健中心的内科教学服务中对非 ICU 非机械通气患者的直接观察与记录的生命体征进行的前瞻性观察研究。
在纳入的 368 名住院患者中，直接观察值的中位数呼吸率为 16 次/分钟，记录值的中位数呼吸率为 18 次/分钟，中位数差异为 2 次/分钟（P <.001）。记录值中呼吸率为 18 或 20 次/分钟的占 71.8%（95%CI，67.1%-76.4%），而直接观察测量值中呼吸率为 13.0%（95%CI，9.5%-16.5%）。对于个体患者，记录的呼吸率与直接观察的呼吸率之间的一致性低于脉搏率。
在美国住院患者中，记录的呼吸频率高于直接观察测量值，并且更有可能为 18 或 20 次/分钟。
