1. Vital Signs

2. Vital Signs
Vital signs are important indicators of health states of the body Vitals Signs Defined as: various determinations that provide basic body conditions of the patient

3. Four Main Vital Signs
Temperature
Pulse
Respirations
Blood Pressure

4. Additional Vital Signs
Degree of Pain: scale 1 – 10
Color of skin
Size of pupils & reaction to light
Level of consciousness
Response to stimuli
They are usually the first sign of disease or abnormality in the patient.

5. Healthcare Workers
As a healthcare worker it is your responsibility to measure and record the vital sign of a patient. However it is not your responsibility to reveal this information to the patient – Physician’s responsibility.

6. Temperature
Temperature is the measurement of balance of heat lost and heat produced in the body
Can be measured:
mouth (oral)
Rectum (rectal)
Armpit (axillary)
Ear (aural)
Too high or too low can be a sign of disease or infection

7. Temperature
Most temperatures are measured in Fahrenheit Scale However many healthcare facilities are now using Celsius Scale

8. Temperature Conversion
Fahrenheit to Celsius: Subtract 32 from F temp, than multiply by 5/9 or IE: 212 Degrees F – 32 = X 5/9 or = 100 C

9. Temperature Conversion
Celsius to Fahrenheit: Multiply Celsius Temp by 9/5 or 1.8 and than add 32. IE: 37 degrees Celsius X 9/5 or 1.8 = = 98.6 F

10. Temperature
Normal ranges vary: 97 – 100 degrees F (98.6) 36.1 – 37.8 degrees C (37) Temps vary during the day and where you take them

11. Temperature
Oral – taken in the mouth with thermometer, 3 – 5 minutes Rectal – taken in rectum, 3-5 minutes Axillary – taken under the armpit, 10 minutes Aural – Special thermometer is placed in the ear and measures thermal infrared energy from blood vessels in the ear.

12. Temperature Indications
Hypothermia – low temp, below 95 F
Prolonged exposure to cold
Death occurs below 93 F
Fever – above 101 F, infection or injury
Hyperthermia – above 104 F
Gets above 106, convulsions/brain damage/death

13. Pulse
Pulse is the pressure of the blood felt against the artery wall as the heart contracts & relaxes (beats)
What gets recorded:
Rate
Rhythm
Volume

14. Pulse Rate – refers to the number of beats per minute
Rhythm – refers to regularity of the beats
Volume – refers to the strength
Pulse is usually taken over the radial artery

15. Pulse Measurement
The pulse of a patient can be measured at various sites.
Radial – inner aspect of wrist above the thumb
Brachial – Inner aspect of elbow
Femoral – inner aspect of upper thigh
Popliteal – behind the knee
Dorsalis Pedis – top of arch of foot

16. Pulse Rates
Pulse rates vary by age, sex, body size and physical condition. Adults: Beats per minute-bpm Adult men: bpm Adult Women: bpm Infants: 100 – 160 bpm Bradycardia – pulse under 60 bpm Tachycardia – pulse over 100 bpm except infants

17. Respirations Respirations reflect the breathing rate of the patient
Also note the regularity – rhythm
Character – type (deep, shallow)

18. Respirations
Normal rate is 14 – 18 breaths per minute (sometimes 12 – 20)
Children slightly faster: 16 – 25
Infants: 30 – 50
Words used to describe breathing are also used – labored, shallow, deep, difficulty

19. Breathing Terminology
Dyspnea – difficult or labored Apnea – Absence of respiration Tachypnea – rate above 25 Bradypnea – below 10 Orthopnea – very, very difficult in any other position other than sitting Cheyne-Stokes – periods of dyspnea followed by Apnea

20. Breathing Terminology
Rales – bubbling or noisy sounds caused by mucus or fluid in lungs Wheezing - difficulty in breathing along with high pitched whistling during expiration Cyanosis – a dusky, bluish discoloration of the skin, lips and/or nail beds as a result of decreased oxygen and increase carbon dioxide in blood

21. Measuring Breathing
Best done with the patient unaware that you are doing it.
Count respirations after performing pulse check.
Continue holding wrist and count each inspiration/expiration as one.

22. Blood Pressure
Blood pressure is the force exerted by the blood against the artery walls when the heart contracts and relaxes.
Two readings are recorded
Systolic - contraction
Diastolic - relaxation

23. Measuring Blood Pressure
Instrument: sphygmomanometer Normal Systolic is 120 mm Hg range from 100 – 140 mm Hg Normal Diastolic is 80 mm Hg range from 60 – 90 mm Hg Hypertension – BP to high Hypotension – BP to low

24. Measuring Blood Pressure
Roll up patient sleeve to 5” above elbow
Position arm palm up and supported
Wrap deflated cuff “ above elbow (Center of bladder of cuff should be over brachial artery)

25. Measuring Blood Pressure
Systolic Pressure: tighten valve pump up until pulse is no longer heard, slowly release pressure and record pressure when pulse is first heard. Diastolic Pressure: Continue slowly releasing valve and note when pulse disappears or when there is a significant change in sound.

26. Additional Vital Signs
Apical Pulse – Taken by a stethoscope at the apex of the heart.
Actual heartbeat is heard and counted
Used when radial pulse is weak as in diseased arteries or infants when pulse is to rapid to count