Nurses are Masters at the Fine Art of Caring

Vital Signs: Counting Respirations
©2006-Present By Kathy Quan RN BSN
All Rights Reserved
This article first appeared on in 2006

Respiration is the act or process of breathing. Humans inhale oxygen and exhale carbon dioxide. Oxygen is picked up in the lungs through the circulating blood.
The oxygen is exchanged in the cells and tissues for carbon dioxide which is carried back to the lungs to be exhaled from the body. Respiration is essential to life.
Respiration is Controlled by Your Brain
When more oxygen is needed, or an excess of carbon dioxide needs to exhaled, the brain signals the lungs to increase the respiratory rate and/or to increase the volume of air exchange by breathing deeper. Sometimes an underlying disease process interferes with this signal or the lung's ability to cooperate.
Breathing is an involuntary act controlled by the brain. It can be temporarily controlled consciously such as holding your breath, or purposefully breathing deeper or slower.
Counting Respirations
To count respirations, you need a clock or watch with a second hand. Respirations should be counted when you (or the patient) are at rest. Try to distract the person from knowing you're counting respirations as sometimes this awareness can cause the person to change their breathing pattern.
Often the nurse or doctor will count your pulse first and continue to hold your wrist while it rests on your chest or abdomen. You think they're counting your pulse the whole time, and they've counted both your pulse and respirations.
Don't Double Count
One respiration involves one inhalation and one exhalation. If you're watching the chest rise and fall, you need to count either the rising or the falling only. Count for a whole minute to obtain an accurate respirattory rate.
Average Respiration Rates (at rest):
  • Newborn-1 yr: 40-60/min
  • 1-6 yrs: 18-30/min
  • 7yrs-Adult: 12-24/min
These rates can vary with underlying illness or disease. Consult your healthcare practitioner for individual situations.
Influencing Factors
Fever, colds, flu, other illness and exercise can cause temporary increases in respiration. Underlying diseases such as emphysema, congestive heart failure, chronic bronchitis, asthma and other cardio-pulmonary conditions can more permanently affect a person's respiration rate.
Abnormal Breath Sounds
Gasping, wheezing or other unusual sounds are not normal. They can accompany some of these conditions, but should be reported to your healthcare practitioner especially if they are new.