Physical examination maneuver
Physical Exam
Respiratory Rate
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Without alerting the patient, count the breaths over a full 60 seconds by watching a location with obvious movement during respiration or feeling the chest or abdomen rise.
How to Interpret
Showing 5 of 14 findings
Cardiopulmonary Arrest
Tachypnea (respiratory rate >27 breaths per minute) in a medical inpatient, predicting impending cardiopulmonary arrest
Rule in
Somewhat helpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Moderate
Pneumonia
Tachypnea (respiratory rate ≥20 breaths per minute)
Rule in
Somewhat helpful
Rule out
Not helpful
Evidence:Strong
Pulmonary Embolism
Tachypnea (respiratory rate >20 breaths per minute)
Rule in
Not helpful
Rule out
Minimally helpful
Evidence:Strong
Reduced Left Ventricular Ejection Fraction
Cheyne-Stokes respirations
Rule in
Helpful
Rule out
Not helpfulDerived CI
Evidence:Moderate
Cheyne-Stokes respirations in a patient over 80
Rule in
Somewhat helpfulWide CI
Rule out
—
Evidence:Moderate
Related Bedside Tests
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Heart Rate
Rule in:SHAtrial Fibrillation, SHDecompensation, SHHypothyroidism +15 more
Rule out:HDecompensation, SHAtrial Fibrillation, SHPostoperative Complication +15 more
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Oxygen Saturation
aka Pulse oximetry
Rule in:HMortality, SHPneumonia, MHCardiac Tamponade +8 more
Rule out:ICCardiac Tamponade, NHHepatopulmonary Syndrome, NHMortality +8 more
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Lung Auscultation
Rule in:VHChronic Obstructive Pulmonary Disease, VHPneumothorax, HMainstem Bronchus Intubation +29 more
Rule out:VHChronic Obstructive Pulmonary Disease, HPleural Effusion, SHInterstitial Lung Disease +28 more
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Cardiac Auscultation
Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy +37 more
Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy, VHRight-sided Valvular Lesion +37 more
🎬Video coming soon
Jugular Venous Pressure
Rule in:VHShock, HRight Ventricular Infarction, SHElevated Pulmonary Capillary Wedge Pressure +14 more
Rule out:HRight Ventricular Infarction, SHElevated Pulmonary Capillary Wedge Pressure, SHPulmonary Hypertension +14 more
🎬Video coming soon
Blood Pressure
Rule in:VHHypovolemia, VHMortality, VHStructural Brain Lesion +22 more
Rule out:VHCardiac Tamponade, VHHypovolemia, HLow Cardiac Output +22 more
Related Systems / Regions
Related Diagnoses
Related Chief Complaints
Abdominal DistensionAnkle SwellingChest PainChillsCold ExtremitiesConfusionCoughCough Productive of SputumCoughing Up BloodDouble VisionDrowsinessEarly SatietyExercise IntoleranceExertional DyspneaFatigueFeverHeadacheLeg SwellingLightheadednessLoss of AppetiteLow Blood PressureNauseaNausea and VomitingOrthopneaPain Worse with BreathingPalpitationsParoxysmal Nocturnal DyspneaPinpoint PupilsPleuritic Chest PainRapid BreathingShortness of BreathSlowed BreathingSyncopeUnresponsivenessVision ChangesVomitingWeaknessWeight GainWheezing
References
Research in progress on one or more findings above; ratings may change.
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- Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. doi:10.1001/jama.2016.0287. PMID: 26903338. PMC: PMC4968574. Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):762-774. doi:10.1001/jama.2016.0288. PMID: 26903335. Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. ACCP/SCCM Consensus Conference Committee. Chest. 1992;101(6):1644-55. doi:10.1378/chest.101.6.1644. PMID: 1303622.
- West J, Goodacre S, Sampson F. The value of clinical features in the diagnosis of acute pulmonary embolism: systematic review and meta-analysis. QJM. 2007;100(12):763-769. doi:10.1093/qjmed/hcm113. PMID: 18089542.
- Wang CS, FitzGerald JM, Schulzer M, Mak E, Ayas NT. Does this dyspneic patient in the emergency department have congestive heart failure? JAMA. 2005;294(15):1944-1956. doi:10.1001/jama.294.15.1944. PMID: 16234501. Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia: Wolters Kluwer; 2021. Orient JM. Sapira's Art & Science of Bedside Diagnosis. 4th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2010. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. Circulation. 2022;145(18):e895-e1032. PMID: 35363499.
- Cushing H. Concerning a definite regulatory mechanism of the vasomotor centre which controls blood pressure during cerebral compression. Johns Hopkins Hosp Bull. 1901;12:290-292. Carney N, Totten AM, OReilly C, et al. Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery. 2017;80(1):6-15. doi:10.1227/NEU.0000000000001432. PMID: 27654000. Wan WH, Ang BT, Wang E. The Cushing Response: a case for a review of its role as a physiological reflex. J Clin Neurosci. 2008;15(3):223-228. doi:10.1016/j.jocn.2007.05.025. PMID: 18182296. Posner JB, et al. Plum and Posner's Diagnosis of Stupor and Coma. 4th ed. Oxford: Oxford University Press; 2007.
- Kussmaul A. Zur Lehre vom Diabetes mellitus. Über eine eigentümliche Todesart bei Diabetischen, über Acetonämie, Glycerin-Behandlung des Diabetes und Einspritzungen von Diastase ins Blut bei dieser Krankheit. Deutsches Archiv für Klinische Medizin. 1874;14:1-46. American Diabetes Association. Standards of Care in Diabetes — 2024. Diabetes Care. 2024;47(Suppl 1). Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009;32(7):1335-43. doi:10.2337/dc09-9032. PMID: 19564476. PMC: PMC2699725. Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia: Wolters Kluwer; 2021. Orient JM. Sapira's Art & Science of Bedside Diagnosis. 4th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2010.
- American Heart Association. 2020 Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: Part 4. Boyer EW. Management of opioid analgesic overdose. N Engl J Med. 2012;367(2):146-55. doi:10.1056/NEJMra1202561. PMID: 22784117. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5-TR). 2022. Goldfrank's Toxicologic Emergencies. 11th ed. McGraw Hill; 2019. Wermeling DP. Review of naloxone safety for opioid overdose. Ther Adv Drug Saf. 2015;6(1):20-31. PMID: 25642320. PMC: PMC4308412.
- Fontanarosa PB, Kaeberlein FJ, Gerson LW, Thomson RB. Difficulty in predicting bacteremia in elderly emergency patients. Ann Emerg Med. 1992;21(7):842-848. PMID: 1610043.
- Duron VP, Rutigliano S, Machan JT, Dupuy DE, Mazzaglia PJ. Computed tomographic diagnosis of pneumatosis intestinalis: clinical measures predictive of the need for surgical intervention. Arch Surg. 2011;146(5):506-510. doi:10.1001/archsurg.2011.95. PMID: 21576602.
- Tobin MJ, Perez W, Guenther SM, et al. The pattern of breathing during successful and unsuccessful trials of weaning from mechanical ventilation. Am Rev Respir Dis. 1986;134(6):1111-1118. PMID: 3789513.
- Fieselmann JF, Hendryx MS, Helms CM, Wakefield DS. Respiratory rate predicts cardiopulmonary arrest for internal medicine inpatients. J Gen Intern Med. 1993;8(7):354-360. PMID: 8410395.
- Strauss R, Ewig S, Richter K, Konig T, Heller G, Bauer TT. The prognostic significance of respiratory rate in patients with pneumonia: a retrospective analysis of data from 705,928 hospitalized patients in Germany from 2010-2012. Dtsch Arztebl Int. 2014;111(29-30):503-508. PMID: 25142073. doi:10.3238/arztebl.2014.0503
- McGee S. Cheyne-Stokes breathing and reduced ejection fraction. Am J Med. 2013;126(6):536-540. PMID: 23541375.
- McGee S. Cheyne-Stokes breathing and reduced ejection fraction. Am J Med. 2013;126(6):536-540. doi:10.1016/j.amjmed.2013.01.005. PMID: 23541375.
- McGee S. Evidence-Based Physical Diagnosis. 6th ed. Philadelphia, PA: Elsevier; 2025.
Research last updated September 10, 2026.
