FIRST AID AND EMERGENCY CARE LECTURE 4 Vital Signs

Introduction  Vital Signs are indicators of health status, they are: Temperature, Pulse, Respiration, Blood Pressure  Many factors such as the temperature of the environment, physical activity and effects of illness cause vital signs to change, sometimes beyond a normal range.  Measurement of Vital Signs provides data that can be used to determine a client’s usual state of health (baseline data)

 Vital Signs are quick & efficient way of monitoring a condition or identifying the presence of problems.

Guidelines for Taking Vital Signs  Vital Signs are a part of the database that is collected during assessment  The process of taking Vital Signs is not a routine but is individualized to the client’s needs and condition  The first aider must be able to:  Measure Vital Signs correctly  Understand & interpret the values  Communicate findings appropriately  Begin interventions as needed

Major Vital Signs  These are signs that are used by nurses and other health professionals to follow-up the patient's condition and to detect any variation in these signs. They include:  Pulse  Respiration  Temperature  Blood pressure  Pupils

 Colors  Level of consciousness  Stroke pain  Ability to move

PULSE  The Pulse is the palpable bounding of blood flow noted at various points in the body  It is an indicator of circulatory status. Circulation is the means by which cells receive nutrients & remove waste products of metabolism.  Reflects the rate of the heart beats  When a Pulse wave reaches a peripheral artery, it can be palpated by palpating the artery lightly against underlying bone or muscle.

 The middle two- three fingers of the hand are used to palpate a peripheral Pulse. The tips are the most sensitive parts of the fingers for detecting the pulsation of the arterial wall.  Normal heart rate ranges between beats /min  An abnormally slow, rapid or irregular pulse may indicate a problem in circulatory regulation.

Assessment of common variations in heart rate  Tachycardia: is an abnormally elevated heart rate above100 beats / minute  Bradycardia: is a rate below 60 beats / minutes

Temporal, Carotid, Brachial, Radial

RESPIRATION  Human survival depends on the ability of oxygen (O2) to reach body cells and for carbon dioxide (CO2) to be removed from the cells.  Respiration involves two distinctly different processes: 1. External Respiration: The movement of air between the environment & lungs 2. Internal Respiration: The movement of Oxygen between hemoglobin & single cell

 It is the means by which oxygen enters the blood through the lungs during breathing in and carbon dioxide is expelled during breathing out.  Normal Respiratory Rate: Adults normally breathe smoothly, and uninterrupted,12-20 b/m

 You can directly assess only the process of external Respiration, specifically by assessing ventilation.  The Rate, Depth & Rhythm of ventilatory movements indicate the quality & efficiency of the respiratory process  Depth: Deep, Shallow, Normal  Rhythm: Regular, Irregular

TEMPERATURE  Temperature is the “hotness” or “coldness” of a substance  The body’s Temperature remains within a relatively narrow range for optimal function  A person’s body Temperature remains relatively stable despite internal extremes (Ex. Metabolic changes) or external conditions (Ex. Climatic Temperature).

 Average body temp is 37 degrees Centigrade  A thermometer registers the body’s core Temperature.  When the body’s core Temperature rises above normal, Hyperthermia occurs. When the body’s core Temperature falls below normal, Hypothermia occurs.

BLOOD PRESSURE  Blood Pressure is the force exerted by the blood against a vessel wall.  The standard unit for measuring Blood Pressure is millimeters of mercury (mmHg).  The measurement indicates the heights to which the Blood Pressure can raise a column of mercury.  During a normal cardiac cycle, Blood Pressure reaches a peak that is followed by a trough:

 The peak or maximum pressure occurs during Systole as the left ventricle pumps blood into the aorta,  The trough occurs during Diastole as the ventricle relaxes.  It means the force required by the heart to pump blood from the ventricles of the heart into the arteries. It is measured in systolic (contraction of ventricles) and diastolic pressure (relaxation of ventricle).

 Normal Bp:120/80 or 100/70 mm/Hg  Range:  Systolic (90-140)/  Diastolic (60-90)  Hypertension: High blood pressure  Hypotension : Low blood pressure  Vital Signs According to Age

PUPILS  Check the pupils for size, equality and reactivity  Examine both eyes (pupils reaction to the light = restriction)

COLOUR  Color of the skin and mucous membrane, (conjunctiva, inside of the lips)  Cyanosis ( bluish discoloration of the skin )

LEVEL OF CONSCIOUSNESS  Used during :  Cardiac arrest,  Head injuries and  Any comatose patient to assess responsiveness

REACTION TO PAIN  in case of cardiac arrest, response to painful stimuli can be tested  a pin or sharper object can be used in assessing reaction to pain

ABILITY TO MOVE  If the patient is conscious and if spinal or neck injury is suspected assess the patient's ability to move his upper and lower extremities.