RT Journal Article
SR Electronic
T1 The accuracy and feasibility of respiratory rate measurements in acutely ill adult patients by GPs: a mixed-methods study
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP BJGPO.2022.0029
DO 10.3399/BJGPO.2022.0029
VO 6
IS 4
A1 Loots, Feike J
A1 Dekker, Irma
A1 Wang, Ruo Chen
A1 van Zanten, Arthur RH
A1 Hopstaken, Rogier M
A1 Verheij, Theo JM
A1 Giesen, Paul
A1 Smits, Marleen
YR 2022
UL http://bjgpopen.org/content/6/4/BJGPO.2022.0029.abstract
AB 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 (OOH) 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 with a reference measurement. In the event that the respiratory rate was not counted, GPs were asked to estimate the rate (dichotomised as ≥22 breaths per minute or <22 breaths per minute).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% confidence interval [CI] = -5.7 to 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% to 98%) was found when the GP counted the rate, and a sensitivity of 43% (95% CI = 22% to 66%) when GPs estimated respiratory rates. GPs reported both medical and 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.