Vital SignsVital Signs

ObjectiveObjective::

- Students will be able to assess the vital - Students will be able to assess the vital signssigns

- Students will be able to explain what is - Students will be able to explain what is being assessed when checking the vital being assessed when checking the vital

signssigns

What are the Vital SignsWhat are the Vital Signs

Measurements of the body's most Measurements of the body's most basic functions. basic functions.

Vital to lifeVital to life– If one or more is missing or If one or more is missing or

compromised = compromised = medical emergencymedical emergency

– Vital signs are useful in detecting or Vital signs are useful in detecting or monitoring medical problemsmonitoring medical problems

The Vital SignsThe Vital Signs

Heart Rate (Pulse)Heart Rate (Pulse)

Breathing Rate (Respiration)Breathing Rate (Respiration)

Blood PressureBlood Pressure

TemperatureTemperature

PulsePulse Heart RateHeart Rate Each “pulse” represent the beat of Each “pulse” represent the beat of

your heartyour heart The pulse rate may fluctuate and The pulse rate may fluctuate and

increase with exercise, illness, injury, increase with exercise, illness, injury, and emotions and emotions

Average resting heart rateAverage resting heart rate– 60 to 100 bpm (beats per minute)60 to 100 bpm (beats per minute)– Adults (60-80 bpm)Adults (60-80 bpm)– Child (80-100 bpm)Child (80-100 bpm)– Lance Armstrong: 32–34 bpmLance Armstrong: 32–34 bpm

Body TemperatureBody Temperature

The normal body temperature of a The normal body temperature of a person varies depending on gender, person varies depending on gender, recent activity, food and fluid recent activity, food and fluid consumption, time of day, and, in consumption, time of day, and, in women, the stage of the menstrual women, the stage of the menstrual cycle. cycle.

According to the AMAAccording to the AMA– Normal body temp – 97.8 – 99.1 degrees Normal body temp – 97.8 – 99.1 degrees

Fahrenheit (normal is often considered Fahrenheit (normal is often considered 98.6)98.6)

Places to take the Places to take the TemperatureTemperature

Oral – mouthOral – mouth Aural – earAural – ear Axillary – armpitAxillary – armpit Rectal – rectumRectal – rectum

*** most accurate – rectal*** most accurate – rectal

***Least accurate - Axillary***Least accurate - Axillary

Problems with body temp.Problems with body temp.

Fever – above 100Fever – above 100 Hypothermia – below 95Hypothermia – below 95

How to check your pulseHow to check your pulse

Using the first and second fingertips, press Using the first and second fingertips, press firmly but gently on the arteries until you firmly but gently on the arteries until you feel a pulse. feel a pulse.

Begin counting the pulse when the clock's Begin counting the pulse when the clock's second hand is on the 12. second hand is on the 12.

Count your pulse for 60 seconds (or for 15 Count your pulse for 60 seconds (or for 15 seconds and then multiply by four to seconds and then multiply by four to calculate beats per minute). calculate beats per minute).

When counting, do not watch the clock When counting, do not watch the clock continuously, but concentrate on the beats continuously, but concentrate on the beats of the pulse. of the pulse.

What are you feeling?What are you feeling?

Superficial arteries expanding as Superficial arteries expanding as blood passes through themblood passes through them

Expulsion of blood from the heartExpulsion of blood from the heart Pulse LocationsPulse Locations

Neck (carotid Pulse)Neck (carotid Pulse)

Wrist (Radial Artery)Wrist (Radial Artery)

““other pulses”other pulses”

Any “superficial Any “superficial artery”artery”

Popliteal – behind Popliteal – behind kneeknee

Femoral – groinFemoral – groin Dorsi Pedis – footDorsi Pedis – foot Brachial – ArmpitBrachial – Armpit

Using the heart rateUsing the heart rate

Max HR 220 minus your ageMax HR 220 minus your age– Multiply that number by .65 = 65% of Multiply that number by .65 = 65% of

maxmax– Multiply that number by .85 = 85% of Multiply that number by .85 = 85% of

maxmax 65% - 85% is the training zone65% - 85% is the training zone Figure out yours…..Figure out yours…..

Respiration RateRespiration Rate

Harder to assess than heart rateHarder to assess than heart rate Watch the chest rise and fallWatch the chest rise and fall 12 to 18 breaths a minute is 12 to 18 breaths a minute is

considered normalconsidered normal

More than 25 and less than 12 More than 25 and less than 12 breaths a minutes is considered breaths a minutes is considered abnormalabnormal

Respiratory DistressRespiratory Distress

Labored breathing or difficulty Labored breathing or difficulty breathing is a medical emergencybreathing is a medical emergency

Partial or Complete Airway Partial or Complete Airway ObstructionObstruction

– Contact EMSContact EMS– CPRCPR

Blood PressureBlood Pressure

The pressure exerted by circulating The pressure exerted by circulating blood on the walls of blood vesselsblood on the walls of blood vessels

SphygmomanometerSphygmomanometer – instrument – instrument used to assess BPused to assess BP

Normal:Normal:– 90/60 mm/Hg to 120/80 mm/Hg90/60 mm/Hg to 120/80 mm/Hg

http://www.youtube.com/watch?v=luppKLO74vg

SystolicSystolic pressure is the pressure of pressure is the pressure of the blood flow when the heart beatsthe blood flow when the heart beats– First sound heardFirst sound heard

DiastolicDiastolic pressure is the pressure pressure is the pressure between heartbeats between heartbeats – Last sound is heardLast sound is heard

BP measurementsBP measurements

Optimal less than 120 / less than 80Optimal less than 120 / less than 80 Normal less than 135 / less than 85Normal less than 135 / less than 85 High 130-139 / 85-89High 130-139 / 85-89 Hypertension 140 or higher / 90 or Hypertension 140 or higher / 90 or

higherhigher

Hypotension <90 / <60Hypotension <90 / <60– Low Blood PressureLow Blood Pressure

High Blood PressureHigh Blood Pressure

Causes the heart to work “harder” Causes the heart to work “harder” – Leaves the heart and the arteries more Leaves the heart and the arteries more

prone to injuryprone to injury High Blood Pressure increases the High Blood Pressure increases the

risk of heart attack, stroke, damage risk of heart attack, stroke, damage to the eyes, kidney failure, to the eyes, kidney failure, atherosclerosis and congestive heart atherosclerosis and congestive heart failure. failure.

Causes of High Blood Causes of High Blood PressurePressure

Heredity Heredity Race (African Americans are more likely to Race (African Americans are more likely to

develop high blood pressure) develop high blood pressure) Males (men have a greater chance of developing Males (men have a greater chance of developing

high blood pressure than women until age 55.  high blood pressure than women until age 55.  However, at over the age of 75, women are more However, at over the age of 75, women are more likely to develop high blood pressure than men).  likely to develop high blood pressure than men). 

Sodium sensitivity (salt) Sodium sensitivity (salt) Obesity and overweight Obesity and overweight Heavy alcohol consumption Heavy alcohol consumption Sedentary lifestyle Sedentary lifestyle Diabetics or individuals with gout or kidney Diabetics or individuals with gout or kidney

disease disease Age (the older people get, the more prone to high Age (the older people get, the more prone to high

blood pressure) blood pressure) Some medications Some medications

Other “vital” signs to checkOther “vital” signs to check Pupil responsePupil response

– PEARL (Pupils Equal And Responsive to PEARL (Pupils Equal And Responsive to Light)Light)

– constricted pupils – injury to the central nervous constricted pupils – injury to the central nervous system and/or intake of depressant drugssystem and/or intake of depressant drugs

– dilated pupils – head injury, shock, hemorrhage dilated pupils – head injury, shock, hemorrhage and/of intake of stimulant drugand/of intake of stimulant drug

Level of ConsciousnessLevel of Consciousness– APVU Scale APVU Scale

http://www.youtube.com/watch?http://www.youtube.com/watch?v=PGrahDehZFcv=PGrahDehZFc Alert / Pain / Voice / UnresponsiveAlert / Pain / Voice / Unresponsive

Sensory ChangesSensory Changes– Bilateral comparisonBilateral comparison

Skin Color Skin Color

Weakness (Bilateral Comparison)Weakness (Bilateral Comparison)

Normal Vital Signs for AdultsNormal Vital Signs for Adults(according to Medline Plus)(according to Medline Plus)

Blood pressure: 90/60 mm/Hg to Blood pressure: 90/60 mm/Hg to 120/80 mm/Hg120/80 mm/Hg

Breathing: 12 - 18 breaths per minuteBreathing: 12 - 18 breaths per minute Pulse: 60 - 100 beats per minutePulse: 60 - 100 beats per minute Temperature: 97.8 - 99.1 degrees Temperature: 97.8 - 99.1 degrees

Fahrenheit / average 98.6 degrees Fahrenheit / average 98.6 degrees FahrenheitFahrenheit