Tripod Breathing or “tripoding” as mentioned in this video usually occurs in patients with advanced lung disease, like COPD will oftentimes assume a tripod position (leaning forward, hands on knees) when breathing difficulties occur. This position optimizes respiratory mechanics.
Before starting bedside shift report with visitors present, you could ask the patient’s permission to discus his/her care in front of the family members/visitors or if they should wait outside. I prefer to ask all visitors to wait outside the door. Then, once they are outside, ask the patient who, if any, they would like to be brought in the room for the shift report. This avoids awkwardness placed on the patient of choosing in front of their company.
If the patient is unable to speak for themselves and there are visitors/family members present, ensure the guest(s) are cleared to discus your patient’s care.
Notice how they use hand sanitizer as they enter the room.