Flash mob research: a single-day, multicenter, resident-directed study of respiratory rate

Chest. 2013 Jun;143(6):1740-1744. doi: 10.1378/chest.12-1837.


Background: Vital signs are critical data in the care of hospitalized patients, but the accuracy with which respiratory rates are recorded in this population remains uncertain. We used a novel flash mob research approach to evaluate the accuracy of recorded respiratory rates in inpatients.

Methods: This was a single-day, resident-led, prospective observational study of recorded vs directly observed vital signs in nonventilated patients not in the ICU on internal medicine teaching services at six large tertiary-care centers across the United States.

Results: Among the 368 inpatients included, the median respiratory rate was 16 breaths/min for the directly observed values and 18 breaths/min for the recorded values, with a median difference of 2 breaths/min (P < .001). Respiratory rates of 18 or 20 breaths/min accounted for 71.8% (95% CI, 67.1%-76.4%) of the recorded values compared with 13.0% (95% CI, 9.5%-16.5%) of the directly observed measurements. For individual patients, there was less agreement between the recorded and the directly observed respiratory rate compared with pulse rate.

Conclusions: Among hospitalized patients across the United States, recorded respiratory rates are higher than directly observed measurements and are significantly more likely to be 18 or 20 breaths/min.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Biomedical Research / methods
  • Chi-Square Distribution
  • Data Collection / methods
  • Female
  • Humans
  • Inpatients
  • Internal Medicine / education
  • Internship and Residency
  • Male
  • Prospective Studies
  • Respiratory Rate*
  • Statistics, Nonparametric
  • United States