Normal Respiratory Rate for Adults
The normal respiratory rate for an adult is 12-20 breaths per minute. 1, 2
Normal Respiratory Rate Parameters
- The American Heart Association guidelines indicate that a normal adult respiratory rate is approximately 10-12 breaths per minute when providing rescue breaths to a patient with spontaneous circulation 1
- In clinical practice, the normal resting respiratory rate for adults typically ranges from 12-20 breaths per minute 2, 3
- Respiratory rate is a fundamental vital sign that is highly sensitive to different pathological conditions and stressors, making it an important clinical parameter to monitor accurately 2
Measurement Recommendations
- Respiratory rate should be measured by counting breaths for a full 60 seconds for maximum accuracy 4
- Measurements taken over shorter periods (15 or 30 seconds) and then multiplied show significant bias and limits of agreement compared to full minute measurements 4
- When counting for a full minute, the mean difference between standardized clinical approach and electronic measurements was found to be only 0.3 breaths per minute in hospitalized patients 5
Clinical Significance
- Respiratory rate is often the first vital sign to change in deteriorating patients, making accurate measurement crucial 5
- Tachypnea (elevated respiratory rate) can be an early sign of life-threatening conditions such as sepsis 6
- Abnormal respiratory rates are more reliably detected with measurements made over a full minute 4
Common Pitfalls in Respiratory Rate Assessment
- Respiratory rates are frequently estimated rather than counted in clinical practice, leading to inaccuracies 3, 6
- Studies show that estimated respiratory rates often cluster around 18 and 20 breaths per minute, suggesting these are used as "normal" default values rather than actual measurements 3
- When GPs estimate rather than count respiratory rates, sensitivity for detecting elevated rates (≥22 breaths/min) drops from 86% to 43% 6
- In hospital settings, respiratory rates are often recorded inaccurately, even among patients with cardiopulmonary compromise 3
Special Considerations
- During CPR in adults with an advanced airway in place, the American Heart Association recommends delivering 1 breath every 6 seconds (10 breaths per minute) while continuous chest compressions are being performed 1
- For patients with spontaneous circulation who require ventilatory support, healthcare providers should deliver rescue breaths at a rate of about 1 breath every 6 seconds, or approximately 10 breaths per minute 1
- Excessive ventilation (greater than 25 breaths per minute) during resuscitation should be avoided as it may be associated with worse outcomes 1