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Respiratory Distress Observation Scale (RDOS) for patients unable to self-report dyspnea

Respiratory Distress Observation Scale (RDOS) for patients unable to self-report dyspnea
Variable 0 points 1 point 2 points Total
Heart rate per minute <90 beats 90 to 109 beats ≥110 beats  
Respiratory rate per minute ≤18 breaths 19 to 30 breaths >30 breaths  
Restlessness: Nonpurposeful movements None Occasional, slight movements Frequent movements  
Paradoxical breathing pattern: Abdomen moves in on inspiration None   Present  
Accessory muscle use: Rise in clavicle during inspiration None Slight rise Pronounced rise  
Grunting at end-expiration: Guttural sound None   Present  
Nasal flaring: Involuntary movement of nares None   Present  
Look of fear None   Eyes wide open, facial muscles tense, brow furrowed, mouth open, teeth together  
Total  
Instructions for use:
  1. RDOS is not a substitute for patient self-report if able.
  2. RDOS is an adult assessment tool.
  3. RDOS cannot be used when the patient is paralyzed with a neuromuscular blocking agent.
  4. Count respiratory and heart rates for 1 minute; auscultate if necessary.
  5. Grunting may be audible with intubated patients on auscultation.
References:
  1. Campbell ML, Templin TN. Intensity cut-points for the Respiratory Distress Observation Scale. Palliat Med 2015; 29:436.
  2. Campbell ML, Kero KK, Templin TN. Mild, moderate, and severe intensity cut-points for the Respiratory Distress Observation Scale. Heart Lung 2017; 46:14.
Reproduced with permission from Margaret L. Campbell, PhD, RN. Originally published in: Campbell ML, Templin T, Walch J. A Respiratory Distress Observation Scale for Patients Unable To Self-Report Dyspnea. J Palliat Med 2010; 13:285.
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