Accuracy of student paramedics when measuring adult respiratory rate : a pilot study

Introduction: Abnormal respiration rate (RR) is commonly undervalued in the out-of-hospital environment despite its use as a predictive marker for physiological decline. The need for paramedicine students to manually measure RR is therefore important. The aims of the study were: 1) to determine the accuracy of manually measured RR when performed by second-year paramedicine students on healthy volunteers in a simulated environment; and 2) to provide data to inform design of a larger study. Methods: This pilot study utilised a prospective double-blinded observational design, in which neither the participants nor the healthy volunteers knew the specific aim of the study. Paramedicine students manually recorded RR along with a range of vital signs including non-invasive manual blood pressure, heart rate, oxygen saturation, temperature and 4-lead electrocardiogram on healthy volunteers. Capnography was used as the gold standard to confirm observed respiratory rates. Intra-class correlation was used to assess agreement between manual RR and capnography. Results: Thirty-six complete sets of data were recorded. There was strong agreement between paramedicine student and capnography measurements (ICC 0.77; 95% CI 0.54-0.88). Accuracy of paramedicine students to measure RR of the opposite gender showed no statistical difference when female students (F=0.05, p=0.83) or male students (F=0.04, p=0.84) measured. Conclusion: The manual RR measured by paramedicine students agreed well with capnography irrespective of the gender of the patient or paramedicine student. These data suggest the two measurements could be used interchangeably, although the difference between statistical and clinical significance should be further investigated.