VITAL SIGNS
 Assessment of pulse, respiration, blood
pressure, and temperature.
 Important for health care providers to know
what are normal and abnormal vital signs.
 Homeostasis
 A state of equilibrium within the body
maintained through the adaptation of
body systems to changes in either the
internal and external environment.
 When injury/illness occurs, the body’s
ability to maintain homeostasis is
impaired
o Which will show in a person’s
Vital Signs.
 We need to monitor our vital signs because we
are warm-blooded
 Lower capacity to adapt unlike cold-
blooded animals
 Multiple taking of vital signs may be needed
since it changes due to factors such as eating,
walking, etc.
Four Main Vital Signs Equipment Used
1) Thermometer – Temperature
2) Stethoscope or Palpitation – Pulse
3) Sphygmomanometer – Blood Pressure
4) Watch or Clock – Respirations
5) Pain Scale – Pain
 Wong Bakers Pain Scale – Pediatrics
 Numerical Pain Rating Scale (0–10) –
Adults
PULSE
 A measurement of the heart beat using the
fingers to palpate an artery or a stethoscope to
listen to the heartbeat.
 Can only be felt in an artery; arteries are the
vessels that carry blood away from the heart to
the rest of the body.
 Blood vessels expand and contract every time
the heart beats.
 Blood flows though the vessels and waves of
blood cause a rhythmic “thumping” in the
arteries.
 A pulse tells us how often the heart beats.
 A change in pulse indicates a change in a
patient’s status.
 Examples
o Rapid but weak = shock
o Absence = cardiac arrest
 Most common place to take a pulse is at the
radial or carotid pulse.
 Wrist – Less Invasive
 Chest – Most Invasive
 Pulse rates vary depending on:
 Age
 Size of Patient
 Physical Condition
 Recorded in beats per minute (bpm).
 Artery has its own pressure; different with the
veins since veins have valves that prevent
backflow of blood
 Bleeding or hemorrhage – Reason for shock
 Babies have higher BPM
 Their hearts have to compensate since
their body parts are not yet fully
developed.
 Epinephrine (1 cc to 2 cc) – Revives the heart
 Cubic Centimeter
Normal Pulse Ranges
 Adult: 60 – 100 bpm
 Well-Conditioned Athlete: 50 – 60 bpm
 Because the heart muscles receive
more exercise
 Babies to Age 1: 100 – 160 bpm
 Children Ages 1–10: 60 – 140 bpm
 Children Ages 11–17: 60 – 100 bpm
Terminologies
 Tachycardia – Pulse rates higher than normal
(Above 100 in adults)
 Bradycardia – Pulse rates lower than normal
(Below 60 in adults; different for well-
conditioned athletes)
 Rhythm of Pulse – Regular (doesn’t change) or
Irregular (speeds up and/or slows down).
 Strength or quality of pulse – Weak or Strong.
 When noting pulse rate on a medical form,
indicate:
 Rate – (Ex: 65 bpm)
 Regularity of rhythm
 Strength or Quality
Measuring Pulse
 Place the patient’s hand in a resting position on
a surface palm up.
 Feel along the inside of the wrist with your
fingertips, locating the radial pulse below the
thumb.
 Do not use your thumb, as it has a pulse of its
own.
 Look at your watch or clock and find a starting
point.
 Count the beats you feel for 1 full minute
 If the pulse is irregular, count for a full minute
and don’t multiply.
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Different Pulse Sites
 Radial Pulse
 Record your own radial pulse; take
turns and record your partner’s radial
pulse.
 Carotid Pulse
 Use the pads of your first 2 fingers;
place them directly over one side of the
front of the patient’s neck.
RESPIRATION
 Breathing; the process of bringing oxygen into
the body and expelling carbon dioxide from the
body.
 Consists of one inspiration and one expiration.
 Measured by rise and fall of the chest.
 Oxygen is brought into the body to be utilized
by cells.
 Carbon dioxide is expelled because it is a waste
product of the cells.
 If breathing patterns are altered and the body is
deprived of oxygen, serious damage can occur
to the vital organs.
 Absence of respiration indicates a blocked
airway or death.
 Arrhythmia – Irregular breathing
 Don’t tell the patient that you’re taking their
respiratory rate
 Because they well be conscious of their
breathing.
Normal Respiration Ranges
 Age 15 and Older: 15 to 20 breaths per minute
 A Well-Conditioned Athlete: 6 – 8 breaths per
minute
RESPIRATION PATTERNS
1) Abdominal
 Respirations using primarily the abdominal
muscles while the chest is mostly still
2) Apnea
 Stopped breathing; temporary or permanent
3) Bradypnea
 Abnormally slow breathing
4) Cheyne-Stokes Respiration
 Irregular breathing pattern of periods of apnea
lasting 10–60 seconds followed by periods of
fast & slow breathing
 Associated with cardiorespiratory arrest
5) Decreased
 Very little air movement in the lungs
6) Dyspnea
 Difficult or painful breathing; shortness of
breath
7) Hyperpnea or Tachypnea
 Breathing that is faster or deeper;
hyperventilation
8) Kussmaul’s Breathing
 Deep, gasping respirations
 Most commonly associated with
conditions that cause metabolic
acidosis, particularly diabetes
 Metabolic acidosis
o Occurs when the body produces
too much acid.
 Ketoacedosis
o Liver breaks down fat &
proteins in response to a
perceived need for respiratory
substrate
9) Labored Breathing
 Difficult breathing that uses shoulder muscles,
neck muscles, and abdominal muscles
Measuring Respirations
 When a person focuses on their breathing
pattern, the rate of respirations is often altered.
 Therefore, it is best to not tell a patient you are
watching their breathing pattern.
 Look at your watch and find a starting point.
 Count each time the patient’s chest rises & falls
 1 rise and fall = 1 single respiration
 Count respirations for full one minute.
 If breathing is irregular, count for a full minute
BLOOD PRESSURE
 The measurement of the pressure exerted by
the circulating blood against the walls of the
arteries.
 Systolic Pressure
 The top number of your BP.
 The BP when the heart contracts.
 Diastolic Pressure
 The bottom number of your BP.
 The BP when your heart is at rest.
 BP is affected by several factors:
 Condition of the arteries and the force
of the heartbeat.
 Age, exercise, obesity, food, pain,
stress, stimulants, medications.
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  Gender and heredity can influence a  The internal body temperature.
person’s BP.  The body’s core temperature must remain
 Although BP increases with exercise, it helps to within a relatively narrow range for its systems
lower overall BP because the heart becomes to function properly.
strong and healthy.  Normal Temperature = 98.6 degrees F
 An unhealthy person’s heart has to  Oral temperature is the preferred method.
work harder to circulate blood  Tympanic thermometer – in the ear.
throughout the body.
 Abnormal BP is a sign of various health Measuring Temperature
problems. 1. Wait at least 15 minutes after patient has had
 Lower blood pressure may indicate the anything to eat or drink.
following: 2. Check to make sure the digital thermometer is
 Low oxygen, sleep/relax, internal working.
bleeding 3. Place a disposable cover on the thermometer.
4. Place the probe in the patient’s mouth
Abnormal Blood Pressure underneath of the tongue.
 A systolic value below 100 or above 139 5. Ask the patient to close their lips.
 A diastolic value below 65 or above 89 6. When the thermometer beeps remove it from
 Implications the patient’s mouth.
 Hypotension 7. Dispose of the cover.
o Low Blood Pressure 8. Record the temperature reading.
o May indicate shock,
dehydration, or internal injury.
 Hypertension
o High Blood Pressure
o Can exert extreme pressure on
blood vessels; can lead to
cardiac problems and strokes.
 Possible Causes
 Obesity
 Lack of Exercise
 Too Much Salt in Diet
 Stress

How to Measure Blood Pressure

1. Ask the patient to roll their sleeve about 6
inches above the elbow.
2. Have them extend their arm, palm up, at heart
level.
3. Place the BP Cuff securely around the arm, 2
inches above the bend in the elbow.
4. Be sure that the arrow on the BP cuff is placed
over the brachial artery.
5. Place the earpieces of the stethoscope in your
ears with the tips pointing slightly forward.
6. Place the diaphragm of the stethoscope over
the brachial pulse at the bottom of the BP cuff.
7. Hold the diaphragm with your non-dominant
hand.
8. Close the control valve.
9. Quickly squeeze the bulb with your dominant
hand until you can no longer hear the pulse
(About 140-200)
10. Slowly and steadily open the valve. (This will
release the air in the cuff)
11. Listen for the 1st clear tapping sound. When
you hear it note the number on the gauge -
(Systolic).
12. Continue to steadily deflate until you hear the
last sound, note the number on the gauge –
(Diastolic).

TEMPERATURE
 Core Temperature

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