The smartphone app called RRate can accurately count the breaths of sick children six times faster compared to the traditional method used by doctors and nurses.

Counting the respiratory rate is a relatively straightforward procedure for doctors and nurses: count breaths or the rise and fall of the chest up to 60 seconds. This manual method is routine for providers and respiratory rate monitors which automatically count breaths are commonly used in hospitals.

But monitors and devices that measure vital signs are lacking in many settings. There is also a dearth of health care workers in many places around the world, where many children are afflicted with respiratory ailments, particularly pneumonia, which is the leading cause of death among children worldwide.

If you consider the pressure in these clinical settings to get more things done in less time with less resources, then applications that improve even the simplest procedures like counting breaths are most certainly welcome.

This is what a smartphone app called RRate was designed for -- quicker but no less accurate monitoring of respiratory rate. Developed by researchers at the Child & Family Research Institute (CFRI) at BC Children’s Hospital and the University of British Columbia, the app can count breaths in just 9.9 seconds, or six times faster than the manual method.

App users can simply tap the screen of a mobile phone every time a child inhales. A special algorithm calculates the respiratory rate in under ten seconds, taking into account the variability of respirations if counted manually for a full minute. In addition, the user can see on the screen an animated baby inhaling and exhaling normally, to provide visual feedback and a comparison to the real patient being monitored.

The algorithm was derived from data gathered from 30 subjects with variable respiratory rates from ten standard videos with a mobile phone application. Then, a “sensitivity analysis and an optimization experiment were performed to verify that a RR could be obtained in less than 60 seconds,” and the researchers claim that the “obtained 6-fold increase in mean efficiency combined with a clinically acceptable error makes this approach a viable solution for further clinical testing,” according to the study entitled “Improving the Accuracy and Efficiency of Respiratory Rate Measurements in Children Using Mobile Devices,” which was published recently in PLOS One.

Because care providers can use RRate to quickly determine the respiratory rate without having to count them for a whole minute, the researchers say that the app can save health workers valuable time in patient care.

“Mobile phones are changing how we administer health care, especially in rural settings and developing countries where access to medical devices is limited,” Dr. Walter Karlen, study co-author and postdoctoral fellow at UBC, said in a statement. “With this app, we can give health care workers with few resources faster and more accurate measurements, help them make better decisions, and give them more time with their patients.”  

“We are leveraging the phone’s capabilities of computing, touch screen, and vibrational feedback to measure respiratory rate faster and with more confidence,” said Dr. Karlen.

The researchers say that RRate has great potential in monitoring kids with pneumonia and other respiratory ailments in settings with little resources. They have a plan to pair the RRate app with another mobile phone-based sensor that they developed called Phone Oximeter. This app has the ability to measure blood oxygen levels using just a light sensor and a mobile phone. Together, these mobile phone apps serve as simple-to-use, non-invasive, affordable alternatives to expensive monitoring devices.

The RRate app is available for downloading from the App Store, Google Play, and as a free, non-study app