During a secondary assessment en route, you note an increased respiratory rate. What is the best course of action?

• A. Immediately notify the receiving facility
• B. Repeat the primary assessment and treat as needed
• C. Assess oxygen saturation with a pulse oximeter
• D. Count the number of respirations per minute

Answer: (B)

When a patient’s breathing rate increases during a secondary survey, the priority is to recheck the primary survey findings and treat as needed. This moment signals that the patient’s condition may be changing, so you want to confirm airway patency, adequacy of breathing, and circulation again and address any issues you uncover. By repeating the primary assessment, you can catch problems such as airway obstruction, chest injury, hypoxia, or failing ventilation early and intervene—for example, providing oxygen, assisting ventilation if necessary, suctioning, or repositioning as appropriate. This approach keeps the patient stable during transport and prevents missing a developing threat.

Noting the change and re-evaluating is more immediate than simply notifying the receiving facility, counting respirations, or measuring SpO2 alone, which are useful but don’t by themselves ensure the patient’s airway and breathing are being effectively managed.