The increasing demand for hospital beds, coupled with an ageing population and shorter hospital stays have resulted in increased patient acuity. These patients are at risk of clinical deterioration, which can have life threatening consequences. Patients with cardiac disease are perhaps even more vulnerable, and more at risk of acute deterioration, they are often older and have multiple co-morbidities. Changes in respiratory function are increasingly recognised as the most sensitive indicator of patient deterioration. However there is clear evidence that nurses may lack the required skills and knowledge to undertake a comprehensive respiratory assessment. This paper offers practitioners an opportunity to develop and augment their knowledge and understanding of respiratory assessment. It suggests a systematic model that may be used in clinical practice. By incorporating this model into every day practice patient outcomes can be improved.