Vital Signs
What is meant by “Vital Signs”?
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http://www.youtube.com/watch?v=Hq4jCeEDpA0&list=PLHIhQUuXqYDjPIsGpPy_lWGY80zqMv8e&index=1
Vital Signs
• Measurements of the body’s most basic
functions
• 4 main vital signs routinely monitored by
healthcare providers
– Temperature
– Pulse rate
– Respiration
– Blood Pressure
Temperature
• Oral
– Mouth
• Axillary
– Armpit
• Rectal
– Rectum
• Tympanic
– Ear
• Temporal artery
– Forehead scan
Oral
• Normal range
– 96°F - 100°F
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Most common for adults and older children
Thermometer is placed under tongue
Wait 10-15 minutes after eating or drinking
Patient must keep mouth closed the entire
time
Axillary
• Normal range (usually 1 degree less than oral)
– 95°F - 99°F
• Least accurate way to measure temperature
• Thermometer is placed in armpit
Rectal
• Normal range (usually 1 degree higher than oral)
– 97°F - 101°F
• Most accurate way to measure temperature
• Thermometer is placed in rectum
Tympanic
• Quickest way to take temperature
• Also called aural
• Thermometer is placed in ear
Temporal Artery
• Uses infrared light to measure temperature of
skin over an artery located in the temple
• Thermometer is swiped across the forehead
toward the top of the ear
Temperature
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Activity?
Infections?
Stimulants?
Depressants?
Reading a Mercury Thermometer
• Each long line = one degree
• Each short line = two-tenths of a degree (0.2)
How do you feel?
• What is the temperature of #1?
– 97.4°F
• What is the temperature of #2?
– 101°F
• What is the temperature of #3?
– 101.2°F
• What is the temperature of #4?
– 98.4°F
How do you feel?
• What should #5 look like?
Temperature
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Activity?
Infections?
Stimulants?
Depressants?
Pulse
• Measures how fast the heart is beating
• Always measured in beats per minute (bpm)
• Measured while patient is at rest unless
otherwise ordered by doctor
Pulse Sites
• Radial
– Thumb side of wrist
• Brachial
– Used for infants / blood
pressure
• Apical
– For use with stethoscope
• Carotid
– Sides of neck (used for
CPR)
• Popliteal
– Behind the knee
• Temporal
– Forehead
• Femoral
– Deep inside the upper
thigh
• Pedal pulses
– Foot, used to assess
circulation in lower
extremities
What is a normal pulse rate?
Resting Pulse Rates
Age or Fitness Level
Beats per Minute (bpm)
babies to age 1:
100 - 160
children ages 1 - 10:
60 - 140
children older 11 - 17:
60 - 100
adults:
60 - 100
well-conditioned athletes:
40 - 60
Pulse
• Tachycardia
– Rapid heart rate, over 100 bpm
• Bradycardia
– Slow heart rate, less than 60 bpm
• Rhythm
– Time interval between each beat (should be
regular)
• Force
– Relates to pulse strength
Taking a Radial Pulse
• The radial pulse is used for routine vital signs
• It is felt by placing the first two fingers of one
hand against radial artery (do NOT use thumb)
• Count the pulse for one minute
Taking an Apical Pulse
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Use the stethoscope
Place on left side of chest (just below the nipple)
The heart beat normally sounds as a lub-dub
Each lub-dub is one beat
Count the apical pulse for one minute
Respirations
• Inhalation
– Breathing air in
• Exhalation
– Breathing air out
Normal Respiratory Rates
• Adult = 12-20 per minute
• Children = 18-28 per minute
• Infants = 24-35 per minute
Count respirations when the patient is at rest
1. Patient should NOT know you are counting
2. Watch chest rise and fall
3. Counted right after taking a pulse
Respiratory Vocabulary
• Apnea
– Period without breathing
• Dyspnea
– Difficult breathing
• Orthopnea
– Difficulty breathing unless sitting or standing
• Tachypnea
– Fast breathing – above 24 / min.
• Bradypnea
– Slow breathing – less than 10 / min.
• Cheyne-Stokes
– Periods of apnea followed by gradually increasing respiration
Blood Pressure
• Measures the amount of force exerted against
the walls of the artery by the blood
• Measured in millimeter of mercury (mm/Hg)
• Blood pressure is written as a fraction
– 120/80
Blood Pressure
• Systolic
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Heart is contracting
Pressure in the arteries is highest
Top number of b/p reading
Normal range = 90-140 (adult)
• Diastolic
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Heart is relaxed
Pressure in arteries is lowest
Bottom number of b/p reading
Normal range = 60-90 (adult)
Blood Pressure
• Infants and children have lower blood
pressures than adults
– Newborns = 70/55 mmHg
– 1 year old = 90/55 mmHg
• Blood pressure continues to increase as child
grow
• Adult bp levels reached between 14-18 years
old
Blood Pressure
What equipment will you need?
• Stethoscope
• Sphygmomanometer