SO…..Not that you don’t know…BUT What are vital signs?
What does that actually mean???
VITAL SIGNS are one of the first primary skills that are taught in any health-care related training.
Vital signs (also known as vitals) are a group of the important physiologic signs that indicate the status of the body’s VITAL (life-sustaining) functions. These VITALS can provide information on the general physical health of a person, give clues to possible diseases, and show positive or negative changes of treatments such as from medications.
Although The normal ranges for a person’s vital signs vary with age, weight, gender, and overall Health, Vitals provide data on the person state of health.
The 4 primary vital signs are TEMPERATURE, PULSE/HEART RATE, RESPIRATIONS, and BLOOD PRESSURE. Vital signs may include other measurements, such as the "fifth vital sign" or "sixth vital signs" or more such as Oxygen saturation, Pain, Blood Glucose, Height, Weight, BMI, Menstrual cycle, Level of consciousness (LOC), and C02 LEVEL.
How to take VITAL SIGNS?
First Obtain your equipment…MAKE sure its clean and in working order and calibrated. You will need a Thermometer, Blood Pressure cuff or a Sphygmomanometer, STETHOSCOPE, a watch to count seconds, and a Sp02 monitor (Pulse oximeter).
These may all be part of an Automatic “Vital sign” machine.
Before You see the patient, perform hand hygiene, and put on the appropriate PPE (personal protective equipment). Then introduce yourself to your patient, if you haven’t already, provide privacy, identify the patient via arm band, DOB, and or have them tell you their name.
Tell the patient what you will be doing and what vital signs you will be obtaining. Do not assume that they know what vital signs are, and this is a way to begin educating the patient, and gain their trust.
Tell them, “I’m going to take your vital signs, which are your temperature, pulse, respiration, blood pressure, and oxygenation saturation level…IS THAT OK???
This will let the patient know what you are doing, and what to anticipate, and it will give you consent. Whether they nod yes, roll up their sleeve, give you’re their arm/hand…you have just obtained IMPLIED CONSENT… or they just say YES…that is also a type of consent…….. KEEPS YOU SAFE!
What is implied consent… it is often relayed through actions.
For your information…verbal consent is a little like INFORMED CONSENT…but that deals more with 4 technical principles of
(1) describing the proposed intervention,
(2) emphasizing the patient's role in decision-making,
(3) discussing alternatives to the proposed intervention,
(4) discussing the risks of the proposed intervention and
(5) eliciting the patient's assessment of the patient's understanding of elements 1 through 4.
Did you know, that directly reaching for a patients arm WITHOUT THEIR CONSENT, is an example of a type of ASSAULT...AND TOUCHING THEIR ARM WITHOUT THEIR CONSENT IS BATTERY...And together you committed ASSAULT & BATTERY
Legally, by definition, an assault is the act of inflicting physical harm or unwanted physical contact upon a person; battery is the act of making contact with another person in a harmful or offensive manner. What might not be offensive to you, may be to the patient.
After you have obtained the patients Vital Signs, let them know what they were, and clean the equipment, according to your facilities / hospitals guidelines.
Let’s discuss each vital sign, but remember, the normal / abnormals will vary depending on literature, organization, etc.
Vital Signs: Temperature
To make things easier, here is the temperature formula…
Celsius to Fahrenheit Formula: (°C * 1.8) + 32 = °F
Fahrenheit to Celsius Formula: (°F - 32) / 1.8 = °C
An elevated temperature or FEVER is defined as >100.4 degrees F in adults
Under 3 months rectal temp >100.4 F
RECTAL: 3 months to 3 years T > 102 F BUT age 3 MOS – 6 MOS, + fever, fussy, decreased alertness
OR concerned no matter what temp say…[You / the parent] knows the baby best
ORAL: 3 y/o & older T > 103
NORMAL RANGES
Orally adults is 97 F (36.1 C) and 99 F (37.2 C) Babies 97.9F to 100.4F
Axillary normal is 96.6° (35.9° C) and 98° F (36.7° C).
Axillary is 1 degree lower
Rectally normal is36.6°C - 38°C (97.9°F - 100.4°F)
0.5 to 1 degree higher
*REMEMBER insert ½ to 1 in infants & children Adults 1.5 in
Tympanically normal is 35.4- 37.8 degrees C
0.5 to 1 degree higher
Temporally: normal is 97.4 -100.1°F.
0.5 to 1 degree lower
Infrared :::skin (touchless) 31.0°C to 35.6°C
PULSE / HEART RATE
NORMAL
<1 YR 100-160
1 to 10 yrs 72-120
Adults 60-100
Conditioned athletes 40-60
BRADYCARDIA = < 60
TACHYCARDIA = >100
**COUNT FOR 1 MIN if NOT REGULAR …
If regular count for 30 secs then x 2
The most common Pulse sites are the Radial , carotid, brachial, femoral, apical, Dorsalis Pedis, and Posterior Tibialis.
Pulse rhythms can be described as:
Regular
Irregular
regularly-irregular
irregularly-irregular
Pulse strength or intensity can be described as:
0= absent
1+ weak
2+ normal
3+ Bounding
RESPIRATORY RATE
A respiratory rate is calculated by counting 1 INSPIRATION (BREATH IN) & 1 Expiration (Breath out) = 1 Respiration (or respiratory cycle).
Normals respiratory rates are:
Adults 12-20 breaths per minute (bpm)
5 to 12 yrs 16-22
Kids/children 20-30 bpm
1 to 4 yr 20-40
Infants 35-40
Newborn 30-60
It is best to count concurrently when counting pulse as patients may change their rate, not intentionally, but do.
If reg count for 30 secs then x 2
**COUNT FOR 1 MIN if NOT REGULAR …
You can count respirations visually, or by placing hand on back of patient to feel the rise and fall of chest.
Respirations can be described as Shallow, labored, Tachypneic (fast- as in after running)
BLOOD PRESSURE
To obtain a patient’s blood pressure, ideally they should be seated, relaxed, feet on floor, right sized cuff, (disposable cuff if necessary), and the head of the stethoscope placed properly (1-2 in above fold in arm, Ante-cubital fossa)
A blood pressure cuff will obstruct the flow of blood and will produce a “KOROTKOFF” sound… the thumping sound heard when listening through a stethoscope. The distinctive sound was named after Dr. Nikolai Korotkov, a Russian physician who discovered them in 1905.
General normal of Blood Pressure:
Newborns: 65/45
1 to 4 yrs of age: 90/55
5 to 12 years of age: 100/60
Adults <120/80
PAIN as a vital sign
Pain is subjective, but may be evident in vital signs (Pulse rate, respirations).
Pain is usually measured on a “PAIN SCALE” such as :
The NUMERIC Scale: 1 TO 10
WONG-BAKER FACES PAIN SCALE
FLACC SCALE; CRIES SCALE; COMFORT SCALE; MCGILL SCALE, COLOR-ANALOG SCALE; MANKOSKI SCALE; BRIEF PAIN INVERTORY SCALE; DESCRIPTOR DIFFERENTIAL SCALE OF PAIN INTENSITY
Pain is listed as to location, the where; and Pain quality is described as
SHARP, DULL, ACHY, BURNING. Also consider asking does the pain radiate and what causes it to increase.
Sp02/ OXYGENATION SATURATION
NORMAL IS > OR EQUAL TO 95% ON ROOM AIR
A reading of 88% or below signals hypoxemia.
Room air / atmospheric air contains 21% oxygen (Fi02) 88%-92%
See my YouTube video about “WHAT ARE VITAL SIGNS?” on my channel “NURSE MASTER CHARLIE RN".
Also, be sure to listen to my “VITAL SIGNS” song, which is available on all music streaming platforms.
After reading ALL that...click on this video below to LISTEN to my VITAL SIGNS Song!!!!!!!!!!!!
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