1. Vital Signs Assessment
Chapter 12
Vital Signs Assessment

2. Primary survey Establish Unresponsiveness Ask the victim “Are you OK?”
If no response, active EMS
Check CAB’s
If not breathing, begin CPR
Determine shock or hemorrhage
Assess head  toe for bleeding or trauma

3. The secondary survey
Only begin the secondary survey once the athlete is deemed stable
Begins with an assessment of vital signs
Musculoskeletal Assessment
DOCUMENT EVERYTHING!

4. Vital Signs Pulse rate Respiratory rate Blood pressure temperature
Skin color
Pupillary reaction
Level of consciousness
Movement in the extremities

5. The Pulse
Reflects condition of patient’s circulatory system and cardiac function
Pulse is found in the artery
Vessel that carries blood away from the heart to the rest of the body
Absence of a pulse indicates cardiac arrest or death

6. The Pulse Rate, rhythm and quality are assessed Rate: normal, abnormal
Rhythm: regular, irregular
Quality: weak, strong

7. The Pulse Normal pulse for adults is 60-80 beats per minute (bpm)
Athlete’s may be bpm

8. The Pulse Abnormal pulses indicate trauma
Rapid & weak: shock, bleeding, diabetic coma, heat exhaustion
Rapid and strong: heatstroke, fright
Slow and strong: skull fracture, stroke
No pulse: cardiac arrest, death.

9. The Pulse Higher than average pulse rates = tachycardia
Lower than average pulse rates = bradycardia

10. The Pulse
Can be found in 11 different places on the body
Pulse points

11. The Pulse Radial Carotid Brachial Femoral Popliteal Posterior Tibial
Dorsal pedal

12. The Pulse Use two fingers to measure pulse rate, rhythm, and quality
NEVER USE THE THUMB – WHY?

13. The Pulse First beat measured is calculated as zero 10 sec x 6

14. Vital Signs Pulse rate Respiratory rate Blood pressure temperature
Skin color
Pupillary reaction
Level of consciousness
Movement in the extremities

15. Respiration Process of exchanging oxygen for carbon dioxide
Takes place in the lungs
Regulated by the brain and CO2 levels in the bloodstream
Single respiration consists of one inspiration and one expiration

16. Respiration General guidelines for normal rates are:
15 years and older:
12-20 breaths per minute
Well-trained athlete:
6-8 breaths per minute

17. Respiratory Patterns Abdominal – belly breathing
Apnea – absence of breathing
Tachypnea – rapid breathing
Bradypnea – slow breathing
Cheyne-Stokes respiration – pattern of rapid deep breathing followed by apnea

18. Respiratory Patterns Dyspnea – difficulty breathing
Kussmaul’s breathing – hyperventilation
Caused by too much CO2 in the blood
Labored breathing – shown by using shoulders, neck, back muscles to breath

19. Measuring Respiration
Respiratory rate & pattern are measured
Count inhalations & exhalations
Watch for chest rise & fall
30 sec x 2 = breaths per minute
Describe pattern

20. Measuring Respiration
Never tell the patient you are measuring their respiration
Why?

22. Lung Volumes
The volume of air associated with the phases of the respiratory
Inhalation
exhalation

23. Lung Volumes
Total Lung Capacity (TLC) – the volume of the lungs at maximal inflation
Tidal Volume (TV) – the volume of air moved in and out of the lungs during normal breathing

24. Lung Volumes
Vital capacity (VC) – the volume of air breathed out after maximal inhalation
Peak Expiratory Flow (PEF) – the highest forced exhalation measured with a peak flow meter

26. Peak Flow Meter Measures the highest volume of air a person can exhale
Measured in liters per minute (L/min)
Indicates airway function
Used to monitor the effectiveness of medications (inhalers)

27. Peak Flow Meter

28. Using a PFM
A baseline “personal best” is established over a 2-3 day period
Measures are taken and compared to the baseline value

29. Using a PFM PEF>80% - person clear to workout without limitations
50%<PEF<80% - person should take medication to raise PEF; workout might need to be altered; person should be monitored closely
PEF<50% - the person should be transported for emergency medical care

30. VITAL SIGNS Pulse rate Respiratory rate Blood pressure temperature
Skin color
Pupillary reaction
Level of consciousness
Movement in the extremities

31. Blood Pressure
Measurement of pressure of the blood against walls of arteries
Systolic & Diastolic measurements
Systolic – heart contraction
Top number
Diastolic – heart relaxation
Bottom number

32. Blood Pressure Affected by many factors Amount of blood in body
Fluid levels (dehydration)
Force of heartbeat
Condition of the arteries

33. Blood Pressure Affected by many factors
Age, exercise, sex, obesity, food, pain, stress, stimulants, steroids, medications can increase BP
Weight loss, fasting, depression, blood loss can decrease BP

34. Blood Pressure Hereditary & genetic implications
Exercise increases efficiency of the heart

35. Blood Pressure
Blood pressure is measured in millimeters of Mercury (mm Hg)
Normal blood pressure:
Systolic = mm Hg
Diastolic = mm Hg

36. Blood Pressure High blood pressure is hypertension (135/90)
Cardiac problems or stroke
Low blood pressure is hypotension (110/65)
Hemorrhage, shock, heart attack, internal bleeding, dehydration

37. Blood Pressure

38. Blood pressure Measured with a sphygmomanometer and stethoscope
Process known as auscultation

39. Measuring Blood Pressure
Place cuff around upper arm, just above elbow
Stethoscope head is placed in the antecubital fossa (crook of the elbow

40. Measuring Blood Pressure
Inflate bulb to mm Hg
Open the valve to slowly deflate

41. Measuring Blood Pressure
Listen for heart beat
Whooshing noise
First sound heard is systolic value
Last sound heard is diastolic value

42. Blood Pressure

43. Measuring Blood Pressure

44. Temperature Measures thermal activity in the body
Normal body temp is 98.6o F, 37o C

45. Temperature Elevated temperature (>99.1o) can be due to
Disease, pain, fear, nerves
Decreased temperature (<98.1o)can be due to
Cold exposure, pain, fear, nerves
Accompanied by chills, teeth chattering, blue lips (cyanosis) pale skin (pallor)

46. Temperature Measured at various sites
Oral
Axillary
Tympanic
Rectal
Core temperature is reflected by skin temperature

48. temperature Process depends on method Sterilize thermometer
Insert into mouth, ear drum, armpit
Wait sec
Document reading