Respiratory rate, also known as breathing rate, is the number of times that you breathe in and out per minute. While you may think this does not concern you, knowing how to count it could comes in handy in case you need to help a person with ill health. The breathing rate can show how the heart or lung is doing. A drop or rise is a warning signal that the patient’s condition may be worsening. 

How to Count Respiratory Rate

The number of breaths per minute varies with age and ranges from 12-60 breaths per minute as shown in the table below.

Normal Resting Breathing Rate

How Do I Count a Person's Respirations?

Follow the following steps:

• Have the person sit upright.
• Make sure the person is comfortable and breathing normally, so that he/she doesn’t try to control the breathing which would give you a false rate.
• Using a watch, count how many times the person breathes in and out per minute, by either observing the chest, placing your hand on the chest and feeling the breath or simply listening to the breaths.

When to Contact a Healthcare Provider

Using your knowledge on how to count respiratory rate, you need to contact a healthcare provider if you notice any of the following signs:

• The breathing rate is less than 12 or more than 25.
• The person’s hands are clammy or sweating.
• There is a whizzing or grunting noise when the person breathes.

When to Seek Immediate Medical Care

In case of the following symptoms, call 911 for immediate medical care.

• The person has trouble breathing and is unable to speak.
• You notice the skin between the ribs and neck is pulled inward.
• The person has to lift shoulders when breathing in or sitting upright.
• The person stops breathing.
• There are signs of seizures.
• Nails and lips turn blue.
• The person is disoriented and has trouble sleeping.
• The person is experiencing chest pains and a fast heartbeat.
• The person tightens the lips when breathing in and out.

What Can Abnormal Respiratory Rate Indicate?

How to count respiratory rate? You already know the steps. A respiratory rate that is higher or lower than normal is an indication of something wrong in the body. 

Increased Respiratory Rate

Normally, the cut-off for an average respiratory rate in adults is 20 breaths per minute. An increase to 24 breaths per minute is an indication of a serious condition and can mean a number of things, including the following:

• An asthma attack which is usually characterized by a sharp elevation in respiratory rate
• Dehydration
• Fever raising breathing rate as the body tries to lower its temperature
• Hyperventilation due to stress, anxiety or panic attack
• A problem with the lungs such as lung cancer or pulmonary embolism
• Infections, both common and uncommon, such as tuberculosis, pneumonia, and flu
• Chronic obstructive pulmonary disease (COPD). This is a common cause for increased breathing rate, especially in people with a history of smoking.
• Respiratory distress syndrome in newborns or a mild condition such as TTN (transient tachypnea)
• Diabetic ketoacidosis, due to an increased production of carbon dioxide in the blood, leading to increased acidity and raised rate of breathing
• Overdosing with drugs such as aspirin
• Heart condition such as cardiac arrest

Decreased Respiratory Rate

How to count respiratory rate is a skill worth learning. What if the result is lower than normal? A respiratory rate of less than 12 in some individuals, and 8 in others is a cause for concern. It may be caused by the following:

• Sleep apnea. People with sleep apnea repeatedly stop breathing during sleep. This is characterized by a decreased breathing rate with episodes of increased breathing rate.
• Alcohol
• Drug use and abuse which can suppress respiration
• Abnormal metabolic processes in the body
• Brain problems such as brain damage, injury and stroke. They often lead to a decreased respiratory rate.