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I think realizing that respiratory rate has risen to over 20 does not require waking the patient though? It’ll generally be quite obvious if someone is breathin

by Aeolun 3y ago

I think realizing that respiratory rate has risen to over 20 does not require waking the patient though? It’ll generally be quite obvious if someone is breathing that fast, even when asleep. But yeah, there’s probably different things that work the same way.

matheusmoreira 3y ago
> It’ll generally be quite obvious It's harder than it seems. Increased respiratory frequency can be subtle, it won't be full dyspnea every time. The signs can be missed if not explicitly looked for. Observing respirations requires a well lit room for the examination. > But yeah, there’s probably different things that work the same way. Sepsis diagnosis also includes assessment of mental state. Mental confusion is a symptom of sepsis. Glasgow Coma Scale is a component of Sequential Organ Failure Assessment scores: it includes talking to the patient and evaluating the coherence of verbal responses. https://en.wikipedia.org/wiki/SOFA_score https://en.wikipedia.org/wiki/SOFA_score Can't be done if the patient is asleep or sedated.
- salad-tycoon 3y ago
  There are rate sensors you can put on a chest like an ekg lead. Though being covered in wires is also pretty awful. Or you can use a pen light and watch for rise and fall of chest. Also, Glasgow Coma Scale absolutely can be administered to someone who isn’t awake but this is really just me nit picking, your point about needing to be intrusive or waking people up is correct overall. Certain things are bothersome, some are painful, most of it will wage people up.
  - matheusmoreira 3y ago
    > Glasgow Coma Scale absolutely can be administered to someone who isn’t awake Of course, it is a coma scale after all. Actually applying it to sleeping patients though? Will get you false positives at best: even healthy patients will fail to respond verbally (-4), blink their eyes (-1) and obey commands (-1) if they're asleep. That's a maximum GCS of 9 even if you stop there. If you don't stop there, you might just get punched in the face when they are rudely awakened to the sight of you testing their pain response.

by Aeolun 3y ago

matheusmoreira 3y ago

> It’ll generally be quite obvious It's harder than it seems. Increased respiratory frequency can be subtle, it won't be full dyspnea every time. The signs can be missed if not explicitly looked for. Observing respirations requires a well lit room for the examination. > But yeah, there’s probably different things that work the same way. Sepsis diagnosis also includes assessment of mental state. Mental confusion is a symptom of sepsis. Glasgow Coma Scale is a component of Sequential Organ Failure Assessment scores: it includes talking to the patient and evaluating the coherence of verbal responses. https://en.wikipedia.org/wiki/SOFA_score https://en.wikipedia.org/wiki/SOFA_score Can't be done if the patient is asleep or sedated.

salad-tycoon 3y ago
There are rate sensors you can put on a chest like an ekg lead. Though being covered in wires is also pretty awful. Or you can use a pen light and watch for rise and fall of chest. Also, Glasgow Coma Scale absolutely can be administered to someone who isn’t awake but this is really just me nit picking, your point about needing to be intrusive or waking people up is correct overall. Certain things are bothersome, some are painful, most of it will wage people up.
- matheusmoreira 3y ago
  > Glasgow Coma Scale absolutely can be administered to someone who isn’t awake Of course, it is a coma scale after all. Actually applying it to sleeping patients though? Will get you false positives at best: even healthy patients will fail to respond verbally (-4), blink their eyes (-1) and obey commands (-1) if they're asleep. That's a maximum GCS of 9 even if you stop there. If you don't stop there, you might just get punched in the face when they are rudely awakened to the sight of you testing their pain response.