1. V ITAL S IGNS AND O THER A SSESSMENT S URVEYS T HEORETICAL S ESSION

2. O BJECTIVES At the end of this session, each student should be able to: Define vital signs. Distinguish between normal and abnormal vital signs readings. Recognize common assessment surveys that are evaluated in emergency situations (e.g., pupils, color, and level of consciousness).

3. D EFINITION OF V ITAL S IGNS تعريف العلامات الحيوية Vital signs are indicators to distinguish between living and non-living human being. العلامات الحيوية هي مؤشرات تميز ما بين الحي أو الميت من البشر. The vital signs include: the temperature ( درجة الحرارة ), pulse ( النبض ), respiration ( التنفس ) and blood pressure ( ضغط الدم ). The vital signs are used by physicians, nurses, and paramedics to assess and follow-up the clients’ condition (i.e., to detect any variation over time).

4. T HE P ULSE ( النبض ) Pulse rate reflects the rate of the heart beating. The pulse can be felt where an artery passes ( يمر ) over a bone near the surface of the body. Common pulse sites include: carotid, radial, brachial, and femoral. Pulse rate increases with bleeding, exercise, illness, injury, and emotions.

5. For a healthy adult : Normal heart rate: At least 60 but not more than 100 beats per minute. (60 - 100 bpm). Tachycardia تسارع انقباض القلب : greater than 100 beats per minute. (> 100 bpm). Bradycardia تباطؤ انقباض القلب : less than 60 beats per minute. (< 60 bpm).

6. R ESPIRATION ( التنفس ) Respiration is the means ( واسطة / طريقة ) by which: oxygen (O2) enters the blood through the lungs during breathing in (inspiration الشهيق ), and carbon dioxide (CO2) is expelled ( يُخرج ) during breathing out (expiration الزفير ).

7. For a healthy adult : Normal respiratory rate (RR) (eupnea) is 12-20 breaths/minute. Abnormal increase in respiratory rate is called tachypnea Abnormal decrease in respiratory rate is called bradypnea Absence of breathing ( توقف التنفس ) is called apnea

8. T EMPERATURE ( درجة الحرارة ) Body temperature is measured by a thermometer ( ميزان حرارة ). Normal body temperature (normothermia) ranges from 36 C° to 38 C°. Average body temperature is 37 C° Temperature that is higher than 38 C° is called hyperthermia. Temperature >that is lower than 36 C° is called hypothermia.

9. B LOOD PRESSURE (BP) ( ضغط الدم ) Blood pressure is the force required by the heart to pump blood into the arteries. Blood pressure consists of (1) systolic pressure, and (2) diastolic pressure. Systolic (higher value) is the highest pressure inside the ventricles (i.e., at the end of ventricles' contraction). Diastolic (lower value) is the lowest pressure inside the ventricles (i.e., when the ventricles are relaxed.)

10. Blood pressure is written as (systolic/diastolic). Average normal Blood pressure (BP) is 120/80 mmHg. Normal systolic pressure: 101-139 mmHg. Systolic Hypertension is a systolic pressure of 140 mmHg or above (most of the time). Systolic Hypotension is a systolic pressure of 100 mmHg or lower (most of the time). Normal diastolic pressure: 61-89 mmHg. Diastolic Hypertension is a diastolic pressure of 90 mmHg or above (most of the time). Diastolic Hypotension is a diastolic pressure of 60 mmHg or lower (most of the time).

11. O THER A SSESSMENT S URVEYS 1. P UPILS Check the pupils for size, equality and reactivity to light. Notes: 1. Examine both eyes. 2. Both pupils should constrict equally (when exposed to light).

12. O THER A SSESSMENT S URVEYS 2. C OLOR Assess the color of the skin and mucous membrane (e.g., conjunctiva ملتحمة العين, inside of the lips).

13. O THER A SSESSMENT S URVEYS 3. L EVEL OF C ONSCIOUSNESS (LOC) مستوى الوعي It is important to assess level of consciousness in cases of cardiac arrest ( توقف القلب ), head injuries ( إصابات الرأس ), and coma ( فقد الوعي ).

14. H OW TO A SSESS L EVEL OF C ONSCIOUSNESS ( LOC ) The Glasgow Coma Scale (GCS) provides a more objective way to assess the patient’s LOC. The Glasgow Coma Scale evaluates: 1. best eye response, 2. best motor response, and 3. best verbal response.

15. GCS produces a score from 3 to 15. (A GCS of 15) (highest score) indicates that the patient is awake, alert, oriented, and able to follow simple commands. A GCS of 3 (lowest score) indicates that the patient does not respond to any stimulus and has no motor or eye response, reflecting a very serious neurologic state with poor prognosis. A GCS of 8 or less indicates severe head injury (comatose state) A GCS of 9-12 indicates moderate head injury. A GCS of 13-15 indicates minor head injury.

16. T ERMS U SED TO D ESCRIBE L EVEL OF C ONSCIOUSNESS Alert متنبه يقظ : Follows commands in a timely fashion. Lethargic نوامي كسول : Appears drowsy, may drift off to sleep during examination. Stuporous مصاب بذهول : Requires vigorous stimulation (shaking, shouting) for a response. Comatose مصاب بغيبوبة : Does not respond appropriately to either verbal or painful stimuli.