Abstract
Background Tachypnoea in acutely ill patients can be an early sign of a life-threatening condition such as sepsis. Routine measurement of the respiratory rate by GPs might improve the recognition of sepsis.
Aim To assess the accuracy and feasibility of respiratory rate measurements by GPs.
Design & setting Observational cross-sectional mixed-methods study in the setting of out-of-hours home visits at three GP cooperatives in the Netherlands.
Method GPs were observed during the assessment of acutely ill patients, and semi-structured interviews were performed. The GP-assessed respiratory rate was compared to a reference measurement. GPs were asked to estimate the rate to be ≥22 breaths per minute or not, in case the respiratory rate was not counted.
Results Observations of 130 acutely ill patients were included, and 14 GPs were interviewed. In 33 patients (25%), the GP counted the respiratory rate. A mean difference of 0.27 breaths per minute (95% CI –5.7–6.3) with the reference measurement was found. At a cut-off point of ≥22 breaths per minute, a sensitivity of 86% (95% CI 57%–98%) was found when the GP counted the rate, and a sensitivity of 43% (95% CI 22%–66%) when GPs estimated respiratory rates. GPs reported both medical as practical reasons for not routinely measuring the respiratory rate.
Conclusion GPs are aware of the importance of assessing the respiratory rate of acutely ill adult patients, and counted measurements are accurate. However, in most patients the respiratory rate was not counted, and the rate was often underestimated when estimated.
- Received March 4, 2022.
- Revision received May 1, 2022.
- Accepted May 6, 2022.
- Copyright © 2022, The Authors
This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)