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Baseline Vital Baseline Vital Signs & Signs & SAMPLE SAMPLE HistoryHistory
CH
AP
TER
5C
HA
PTER
5
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Baseline Vital SignsBaseline Vital SignsBaseline Vital SignsBaseline Vital Signs
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Sign:Sign:
Any medical or trauma Any medical or trauma condition displayed by the condition displayed by the patient and identified by the patient and identified by the EMT.EMT.
Examples of signs are hemorrhage, noisy breathing, bone deformities.
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Symptom:Symptom:
Any condition described by the Any condition described by the patient that cannot be patient that cannot be observed.observed.
Examples of symptoms are chest pain, shortness of breath, nausea.
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Vital Signs Vital Signs Breathing:Breathing: Rate, qualityRate, quality
Pulse:Pulse: Rate, character, rhythmRate, character, rhythm
Skin:Skin: Color, temperature, Color, temperature, conditioncondition
Pupils:Pupils: Reactivity, equalityReactivity, equality
Blood pressureBlood pressure
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Average Vital Sign Ranges by Average Vital Sign Ranges by AgeAgeP
120-160
80-140
80-120
70-115
70-115
70-115
70-90
60-80
AGE
Newborn
1 year
3 years
5 years
7 years
10 years
15 years
Adult
R
40-60
30-40
25-30
20-25
20-25
15-20
15-20
12-20
BP
80/40
82/44
86/50
90/52
94/54
100/60
110/64
120/80
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Trending:Trending:
The process of comparing sets The process of comparing sets of vital signs or other of vital signs or other assessment information over assessment information over time.time.
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Level of Level of ConsciousnessConsciousness
Level of Level of ConsciousnessConsciousness
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To assess level of consciousness: To assess level of consciousness:
AA - - AlertAlert and awake; aware of time, place, and awake; aware of time, place, date and persondate and person
VV - - Responds to Responds to verbalverbal stimuli stimuli
PP - - Responds to Responds to painfulpainful stimuli, does not stimuli, does not respond to verbal stimulirespond to verbal stimuli
UU - - Unconscious,Unconscious, does not respond to does not respond to any stimuliany stimuli
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BreathingBreathingBreathingBreathing
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Respirations:Respirations:
One breath in a single cycle of One breath in a single cycle of breathing in and out.breathing in and out.
Can be determined by counting the number of breaths in 30 seconds and multiplying by two.
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Breathing Assessment Breathing Assessment RateRate
Averages 12-20 breaths per minuteAverages 12-20 breaths per minutein adultsin adults
QualityQuality Normal respirations?Normal respirations? Shallow respirations?Shallow respirations? Labored respirations?Labored respirations? Noisy respirations?Noisy respirations?
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Patients often breathePatients often breathe
FASTERFASTERwhen they are ill or injured.when they are ill or injured.
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Abnormal Respiratory Sounds Abnormal Respiratory Sounds
GruntingGrunting StridorStridor SnoringSnoring WheezingWheezing GurglingGurgling CrowingCrowing
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Accessory muscles may be used during labored breathing.
NeckNeckMusclesMuscles
ChestChestMusclesMuscles
IntercostalIntercostalMusclesMuscles
AbdominalAbdominalMusclesMuscles
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Retractions may indicate labored breathing.
SternalSternal
SupraclavicularSupraclavicular
IntercostalIntercostal
SubsternalSubsternal
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PulsePulsePulsePulse
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Key Pulse Points
CarotidCarotid
RadialRadial
BrachialBrachial
FemoralFemoral
PosteriorPosteriorTibialTibial
DorsalisDorsalisPedisPedis
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Assessing the Pulse Assessing the Pulse RateRate
Averages 60-80 beats per minute Averages 60-80 beats per minute in adultsin adults
QualityQuality StrengthStrength (strong or weak)(strong or weak)
RhythmRhythm Regular or irregularRegular or irregular
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Locating the Radial Pulse
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Locating the Carotid Pulse
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Palpate the brachial pulse in
an infant.
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SkinSkinSkinSkin
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Perfusion:Perfusion:
The process of distributing The process of distributing blood to the organs, delivering blood to the organs, delivering oxygen, and removing wastes.oxygen, and removing wastes.
The skin condition is a good indicator of perfusion.
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Assessment of the Skin Assessment of the Skin ColorColor (nail beds, oral mucosa, conjunctiva)(nail beds, oral mucosa, conjunctiva)
Pink?Pink? Pale?Pale? Cyanotic?Cyanotic? Flushed?Flushed? Jaundiced?Jaundiced?
TemperatureTemperature Warm?Warm? Hot?Hot? Cool or cold?Cool or cold?
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Assessment of the Skin continued Assessment of the Skin continued
ConditionCondition Dry?Dry? Wet or moist?Wet or moist? Abnormally dry?Abnormally dry? Clammy (cool & moist)?Clammy (cool & moist)?
Capillary refill Capillary refill (considered an inaccurate indicator of perfusion in patients over the age of 6 years)(considered an inaccurate indicator of perfusion in patients over the age of 6 years)
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Assess skin temperature Assess skin temperature with the back of your with the back of your hand.hand.
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Slow CRT may indicate poor perfusion.
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PupilsPupilsPupilsPupils
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Pupils are normally equal, reactive to light and midsize.
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Constricted PupilsConstricted Pupils
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Unequal PupilsUnequal Pupils
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Dilated PupilsDilated Pupils
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To assess the pupils: To assess the pupils: First evaluate in ambient light for constriction or dilation.First evaluate in ambient light for constriction or dilation.
Next, pass a light source across each pupil and note the response.Next, pass a light source across each pupil and note the response.
Each pupil should constrict in the same manner.Each pupil should constrict in the same manner.
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Blood PressureBlood PressureBlood PressureBlood Pressure
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Blood pressure:Blood pressure:
Measurement of the force the Measurement of the force the blood exerts against the walls of blood exerts against the walls of blood vessels during the heart’s blood vessels during the heart’s contraction and relaxation contraction and relaxation phases.phases.
Systolic: pressure during
contraction Diastolic: pressure during
relaxation
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SystolicSystolic
DiastolicDiastolic
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Changes in successive
blood pressure readings
may provide valuable clues
about the patient’s
condition.
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Measuring BP by Measuring BP by auscultation.auscultation.
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Measuring BP by Measuring BP by palpation.palpation.
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Vital Sign Vital Sign ReassessmentReassessment
Vital Sign Vital Sign ReassessmentReassessment
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Reassess vital signs every Reassess vital signs every 55 minutesminutes for for unstableunstable patients.patients.
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Reassess vital signs every Reassess vital signs every 15 minutes15 minutes for for stablestable patients.patients.
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SAMPLE HistorySAMPLE HistorySAMPLE HistorySAMPLE History
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Patient history:Patient history:
A concise and inclusive set of A concise and inclusive set of information gathered about information gathered about patients and their medical patients and their medical problems.problems.
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SSigns and symptomsigns and symptoms
AAllergiesllergies
MMedicationsedications
PPertinent past medical historyertinent past medical history
LLast oral intake (solid or liquid)ast oral intake (solid or liquid)
EEvents leading to injury or illnessvents leading to injury or illness
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OOnsetnset
PProvocationrovocation
QQualityuality
RRadiationadiation
SSeverityeverity
TTimeime
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SU
MM
AR
YS
UM
MA
RY Baseline Vital SignsBaseline Vital Signs
SAMPLE HistorySAMPLE History