Assessment of Respiratory Rate Monitoring in the Emergency Department

Overview

Journal J Am Coll Emerg Physicians Open

Publisher Elsevier

Specialty Emergency Medicine

Date 2024 May 9

PMID 38721036

Authors

John H Lee

Larry A Nathanson

Ryan C Burke

Brian W Anthony

Nathan I Shapiro

Alon S Dagan

Affiliations

Soon will be listed here.

Abstract

Objectives: This study aimed to compare the different respiratory rate (RR) monitoring methods used in the emergency department (ED): manual documentation, telemetry, and capnography.

Methods: This is a retrospective study using recorded patient monitoring data. The study population includes patients who presented to a tertiary care ED between January 2020 and December 2022. Inclusion and exclusion criteria were patients with simultaneous recorded RR data from all three methods and less than 10 min of recording, respectively. Linear regression and Bland-Altman analysis were performed between different methods.

Results: A total of 351 patient encounters met study criteria. Linear regression yielded an -value of 0.06 (95% confidence interval [CI] 0.00-0.12) between manual documentation and telemetry, 0.07 (95% CI 0.01-0.13) between manual documentation and capnography, and 0.82 (95% CI 0.79-0.85) between telemetry and capnography. The Bland-Altman analysis yielded a bias of -0.8 (95% limits of agreement [LOA] -12.2 to 10.6) between manual documentation and telemetry, bias of -0.6 (95% LOA -13.5 to 12.3) between manual documentation and capnography, and bias of 0.2 (95% LOA -6.2 to 6.6) between telemetry and capnography.

Conclusion: There is a poor correlation between manual documentation and both automated methods, while there is relatively good agreement between the automated methods. This finding highlights the need to further investigate the methodology used by the ED staff in monitoring and documenting RR and ways to improve its reliability given that many important clinical decisions are made based on these assessments.

Citing Articles

Dyspnea Management in Patients Presenting to the Emergency Department at Cantonal Hospital Baselland-A Retrospective Observational Study and Medical Audit.

Debernardi E, Jaun F, Boesing M, Leuppi J, Luthi-Corridori G J Clin Med. 2025; 14(4).

PMID: 40004907 PMC: 11856902. DOI: 10.3390/jcm14041378.

Assessment of respiratory rate monitoring in the emergency department.

Lee J, Nathanson L, Burke R, Anthony B, Shapiro N, Dagan A J Am Coll Emerg Physicians Open. 2024; 5(3):e13154.

PMID: 38721036 PMC: 11077426. DOI: 10.1002/emp2.13154.

Respiratory rate: The third vital sign.

Levine R J Am Coll Emerg Physicians Open. 2024; 5(3):e13153.

PMID: 38721035 PMC: 11077563. DOI: 10.1002/emp2.13153.

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