Vital Signs

Blood pressure

Pulse

Respirations

Temperature

will cover later...

Level of consciousness

pupil status

breath sounds

Signs & Symptoms

Signs are observed or measured

Symptoms are told to you by the patient

Respirations

1. Count number of breaths per minute

2. Assess Quality • Rhythm

• Effort

• Noise

3. Assess tidal volume • Increased

• Normal

• Decreased

Normal values

Adult 12 - 20 per minute

Child 18 - 30 per minute

Infant 30 - 60 per minute

Terms

Apnea = not breathing

Bradypnea = slow breathing

Tachypnea = fast breathing

Hypoventilation = poor tidal volume

Hyperventilation = deep tidal volume

Pulse

Rate Number of beats in one minute or in

30 seconds multiplied by 2

Strength Bounding, strong, or weak (thready)

Regularity Regular or irregular

Pulse Points

Femoral

Apical

Carotid

Radial

Brachial

Temporal

Dorsalis Pedis

Popliteal

Posterior Tibialis

(AKA Medial Tibialis)

normal values

Adult 60 - 100

Child 70 - 120

Toddler 90 - 150

Newborn 120 - 160

Terms

Bradycardia = slow pulse under 60 (adult)

Tachycardia = fast pulse 100 or more (adult)

Blood Pressure

The pressure of the circulating blood against the walls of the arteries.

A drop in blood pressure may indicate:

Loss of blood

Loss of vascular tone

Cardiac pumping problem

Blood pressure should be measured in all patients older than 3 years.

Blood pressure

Systolic - higher number pressure at ventricular contraction

Diastolic - lower number pressure at ventricular relaxation

Measured in millimeters of mercury (mm Hg)

Recorded as systolic/diastolic

Auscultation vs Palpation

Using a sphygmomanometer there are two methods

Auscultation obtains both systolic & diastolic readings

Palpation = to feel only systolic reading obtained

Normal Ranges of Blood Pressure

Age Range

Adults (systolic) 100 to 140 mm Hg

(diastolic) 60 to 90 mm Hg

Children (systolic) 80 to 110 mm Hg

Infants (systolic) 60 mm Hg

terms

Hypotension - low blood pressure

Hypertension - high blood pressure

BP indicators – If you can get

this pulse, the BP is:

Carotid - at least 60 systolic

Femoral - at least 70 systolic

Radial - at least 80 systolic

Pulse Pressure

pulse pressure is the difference between systolic & diastolic readings.

120/80 pulse pressure = 40

156/66 pulse pressure = 90

What is Blood Pressure?

BP = CO x PVR

orthostatic vital signs

AKA - postural vital signs

assessment for hypovolemia/shock

Take blood pressure & pulse supine - sitting - standing

orthostatic vital signs

wait 1 minute after changing positions.

increase in pulse or decrease in blood pressure of 20 points or more equals hypovolemia. Indicates 15% volume loss.

Temperature

Axillary

Oral

Rectal

Other***

Normal = 98.6

core temp

rectal temp

THE MOST ACCURATE METHOD

The Skin

Color

Pink, pale, blue, flushed, or jaundice

Temperature

Warm, hot, or cool

Moisture

Dry, moist, or wet

Capillary Refill

Evaluates the ability of the circulatory system to restore blood to the capillary system (perfusion)

Tested by depressing the patient’s fingertip and looking for return of blood

Remember ...

Treat the patient not the numbers!!!

Look at the whole picture!

END

questions?