Adequate Breathing Signs
Adequate breathing in adults is about 12 to 20 breaths per minute with regular rhythm, equal chest rise, clear breath sounds, and normal skin color. The patient can speak in full sentences.
Signs of Inadequate Breathing
Look for a rate that is too slow or fast, shallow breaths, retractions, nasal flaring, tripod positioning, accessory muscle use, cyanosis, cool clammy skin, and altered mental status. Agonal respirations are not adequate breathing and require ventilation.
Intervention Thresholds
If breathing is inadequate, provide positive pressure ventilation with a BVM and high-flow oxygen. If breathing is adequate but the patient is hypoxic, give supplemental oxygen. The exam frequently asks you to choose between these two options, so focus on the quality of breathing, not just the number on the pulse oximeter.