Respiratory rate: the neglected vital sign

Michelle A Cretikos, Rinaldo Bellomo, Ken Hillman, Jack Chen, Simon Finfer and Arthas Flabouris
Med J Aust 2008; 188 (11): 657-659.
  • Michelle A Cretikos1
  • Rinaldo Bellomo2
  • Ken Hillman3
  • Jack Chen3
  • Simon Finfer4
  • Arthas Flabouris5

  • 1 Centre for Epidemiology and Research, NSW Health, Sydney, NSW.
  • 2 Department of Intensive Care, Austin Hospital, Melbourne, VIC.
  • 3 Simpson Centre for Health Services Research, University of New South Wales, Sydney, NSW.
  • 4 Intensive Therapy Unit, Royal North Shore Hospital, University of Sydney, Sydney, NSW.
  • 5 Intensive Care Unit, Royal Adelaide Hospital, University of Adelaide, Adelaide, SA.


Competing interests:

None identified.

  • 1. Hillman K, Chen J, Cretikos M, et al; MERIT study investigators. Introduction of the medical emergency team (MET) system: a cluster randomised controlled trial. Lancet 2005; 365: 2091-2097.
  • 2. National Confidential Enquiry into Patient Outcome and Death. An acute problem? London: NCEPOD, 2005. (accessed October 2007).
  • 3. Hodgetts TJ, Kenward G, Vlachonikalis IG, et al. The identification of risk factors for cardiac arrest and formulation of activation criteria to alert a medical emergency team. Resuscitation 2002; 54: 125-131.
  • 4. McBride J, Knight D, Piper J, et al. Long-term effect of introducing an early warning score on respiratory rate charting on general wards. Resuscitation 2005; 65: 41-44.
  • 5. Ryan H, Cadman C, Hann L. Setting standards for assessment of ward patients at risk of deterioration. Br J Nurs 2004; 13: 1186-1190.
  • 6. Hogan J. Why don’t nurses monitor the respiratory rates of patients? Br J Nurs 2006; 15: 489-492.
  • 7. Fieselmann JF, Hendryx MS, Helms CM, et al. Respiratory rate predicts cardiopulmonary arrest for internal medicine patients. J Gen Intern Med 1993; 8: 354-360.
  • 8. Goldhill DR, McNarry AF, Mandersloot G, et al. A physiologically-based early warning score for ward patients: the association between score and outcome. Anaesthesia 2005; 60: 547-553.
  • 9. Subbe CP, Davies RG, Williams E, et al. Effect of introducing the Modified Early Warning score on clinical outcomes, cardio-pulmonary arrests and intensive care utilisation in acute medical admissions. Anaesthesia 2003; 58: 797-802.
  • 10. Cretikos M, Chen J, Hillman K, et al. The Objective Medical Emergency Team Activation Criteria: a case–control study. Resuscitation 2007; 73: 62-72.
  • 11. Schein RM, Hazday N, Pena M, et al. Clinical antecedents to in-hospital cardiopulmonary arrest. Chest 1990; 98: 1388-1392.
  • 12. Goldhill DR, McNarry AF. Physiological abnormalities in early warning scores are related to mortality in adult inpatients. Br J Anaesth 2004; 92: 882-884.
  • 13. Harrison GA, Jacques TC, Kilborn G, et al. The prevalence of recordings of the signs of critical conditions and emergency responses in hospital wards — the SOCCER study. Resuscitation 2005; 65: 149-157.
  • 14. West JB. Respiratory physiology: the essentials. 4th ed. Baltimore: Williams and Wilkins, 1990.
  • 15. Attin M, Cardin S, Dee V, et al. An educational project to improve knowledge related to pulse oximetry. Am J Crit Care 2002; 11: 529-534.
  • 16. Bilgin H, Kutlay O, Cevheroglu D, et al. Knowledge about pulse oximetry among residents and nurses. Eur J Anaesthesiol 2000; 17: 650-651.
  • 17. Smith GB, Poplett N. Knowledge of aspects of acute care in trainee doctors. Postgrad Med J 2002; 78: 335-338.
  • 18. Jubran A. Pulse oximetry. Crit Care 1999; 3: R11-R17.
  • 19. Cook C, Smith G. Do textbooks of clinical examination contain information regarding the assessment of critically ill patients? Resuscitation 2004; 60: 129-136.
  • 20. Armitage M, Eddleston J, Stokes T, et al. Recognising and responding to acute illness in adults in hospital: summary of NICE guidance. BMJ 2007; 335: 258-259.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.