sure at the given interval . There are semiautomatic blood pressure diagnostic devices that necessitate pressing a button every time the blood pressure is to be taken . However , besides the fact that they don ’ t have alarms , they leave room for delayed readings or forgetting to press the button and missing a reading altogether .
Respiration rate . Respiration rate is the one baseline vital sign that is not a standard on a basic monitor . Perhaps this is one of the reasons it ’ s termed the forgotten vital sign .
What are your options for obtaining a respiration rate on a monitor ? Typically , respiration rate on a monitor is obtained by electrocardiogram ( ECG ). It works by measuring the thoracic impedance across the ribs , measuring the rise and fall of the chest to calculate the respiration rate . This works best in patients who are still and comfortably sedated . Patient movement and incorrect placement of ECG pads often result in excessive false alarms .
Another way respiration rate is determined through a monitor is by utilizing capnography . As the monitor is measuring the level of end-tidal CO 2 , respiration rate is also determined . This reading is often differentiated with a term such as awRR ( airway respiration rate ) or BRm ( breath rate per minute ).
DOCUMENTATION
The patient ’ s measured vitals must be documented . At all levels of sedation , including nitrous , baseline vital signs must be recorded in accordance with Texas State Board of Dental Examiners Rules 108.7 and 108.8 . This is repeated at every level of sedation .
Everyone must record baseline vital signs . These include :
n Pulse oximetry n Heart rate n Respiratory rate n Blood pressure
While all levels of sedation need baseline vital signs recorded , there are a few variances for the subsequent time-oriented documentation . For example , SpO2 ( oxygen saturation ) must be used for Level 1 sedation only if nitrous is added to a single drug sedative . In terms of the time-oriented record though , records may be documented every 10 minutes , according to the regulations .
For Level 2 ( oral sedation ) and Level 3 ( IV sedation ), it is very plain : records must be documented every 10 minutes .
These include pulse ox , heart rate , respiratory rate , and blood pressure . For Level 4 ( deep sedation ), records must be documented every five minutes .
To fulfill the requirement of having a time-oriented record of sedation , many prefer to have a printer on their monitor . The bottom line is that once the anesthesia or sedation case is complete , the record needs to show values for all the vitals that were monitored .
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