VITAL SIGNS

TIPS FOR YOUR

HEALTH CARE
 VITAL SIGNS
are usually referred to the following
procedures used for assessment in
healthcare. They involve the:

1
Body
2
Pulse Rate
3
Respiratory
4Blood
Temperature Rate Pressure
RADIOGRAPHERS CAN TAKE
VITAL SIGNS
The radiographer must know how to measure each vital sign
to be prepared in case an emergency situation in which
these skills are needed is ever encountered.

Radiographers do not take vital signs on most patients, and

when the need does arise, it is often in response to an urgent
situation.
 WHEN PATIENT COMES
IN THE DIAGNOSTIC
IMAGING DEPARTMENT
NOTE
RADIOGRAPHER MUST KNOW HOW TO MEASURE EACH
VITAL SIGN TO BE PREPARED IN CASE AN EMERGENCY
SITUATION
for an extensive procedure or examination
without a chart and no registered nurse is
available.
A physician’s order is not required for vital signs to be
measured. Unless a registered nurse is present to do so.
 WHEN PATIENT COMES
IN THE DIAGNOSTIC
IMAGING DEPARTMENT
NOTE
VITAL SIGNS MUST BE MEASURED BY
THE RADIOGRAPHER
before and after the patient receives medication,
any time the patient’s general condition
suddenly changes, or if the patient reports
nonspecific symptoms of physical distress such
as simply not feeling well or feeling “different.”
A QUICK REFERENCE TO NORMAL
VITAL SIGNS BY AGE
VITAL SIGNS:
BODY
TEMPERATURE
BODY TEMPERATURE

is the physiologic balance between heat

produced in body tissues and heat lost to
the environment.
controlled by a small structure in the basal
region of diencephalon of the brain called
the hypothalamus.
 FACTORS THAT INFLUENCE BODY
TEMPERATURE

Environment Time of Day Age Weight Hormone

Levels
 FACTORS THAT INFLUENCE BODY
TEMPERATURE

Emotions Physical Digestionof Disease Injury

Exercise food
BODY TEMPERATURE

A patient whose body temperature is

elevated above normal limits is said to
have a fever, or pyrexia.

Fever indicates a disturbance in the heat-

regulating centers of the body, usually as
a result of a disease process. As body
temperature increases, the body’s
demand for oxygen increases.
BODY TEMPERATURE
SYMPTOMS OF A FEVER
increased pulse and respiratory rate
general discomfort or aching
flushed dry skin that feels hot to the touch
chills (occasionally)
loss of appetite

A person with a body temperature below

normal limits is said to have hypothermia,
which may beindicative of a pathological
process.
BODY TEMPERATURE RANGE
MEASURING BODY
TEMPERATURE
There are four areas of the body in which
temperature is usually measured in:
the oral site
the tympanic site
the rectal site
the axillary site.
MEASURING BODY TEMPERATURE
Oral temperature is taken by mouth under the tongue; the
average oral temperature reading is 98.6F (37C).

The axillary temperature is taken in the axilla or armpit. The

average axillary temperature is 97.6F to 98F (36.4C to 36.7C).

Rectal temperature is taken at the anal opening to the

rectum. The average rectal temperature is 99.6F (37.5C).

Tympanic temperature is 0.3 C (0.5 F) to 0.6 C (1 F) .

RADIOGRAPHERS MEASURING
BODY TEMPERATURE
Whatever method of measuring body temperature is
chosen, the radiographer must assemble the necessary
equipment and abide by medically aseptic technique such
as:
washing the hands
wearing gloves
if there is a possibility of coming in contact with blood or
other body fluids.
 PROCEDURES OF MEASURING BODY
TEMPERATURE

TYMPANIC MEMBRANE THERMOMETER

(also called an aural thermometer) is a small,
hand-held device that measures the
temperature of the blood vessels in the tympanic
membrane of the ear. This provides a reading
close to the core body temperature if correctly
placed. The patient may be sitting upright or in a
supine position.
 PROCEDURES OF MEASURING BODY
TEMPERATURE

THE PROCEDURE FOR USE IS:

1. Place a clean sheath on the probe that is to be inserted into the external auditory
canal
2. Place the probe into the external auditory canal and hold it firmly in place until the
temperature registers automatically on the meter held in the non-dominant hand.
3. Remove the probe and read the indicator.
4. Remove the probe’s cover and dispose of it correctly. Remove any gloves and wash
hands.
5. Record the reading. Immediately report any abnormal temperature to the
radiologist in charge of the procedure.
 PROCEDURES OF MEASURING BODY
TEMPERATURE

ELECTRONIC THERMOMETER FOR ORAL TEMPERATURE

The procedure for the electronic thermometer is

the same as for the tympanic membrane
thermometer, except:
the probe is placed under the patient’s
tongue
held in place until the instrument signals that
it has registered a temperature.
 PROCEDURES OF MEASURING BODY
TEMPERATURE

TAKING AN AXILLARY TEMPERATURE

Use of the axillary site is the safest method of
measuring body temperature because it is
noninvasive. It is particularly useful when
measuring an infant’s temperature. When it is
necessary to measure temperature using the
axillary site, an electronic or disposable
thermometer may be used.
 PROCEDURES OF MEASURING BODY
TEMPERATURE

THE PROCEDURE IS AS FOLLOWS:

1. Obtain the instrument to be used.
2. After putting on clean gloves, dry the patient’s armpit with a paper towel
or dry washcloth.
3. Place the thermometer into the center of the armpit.
4. Place the patient’s arm down tightly over the thermometer with the arm
crossed over the chest. Gently hold the arm of a child or a restless adult in
place until the thermometer has registered, usually about 1 minute.
 PROCEDURES OF MEASURING BODY
TEMPERATURE

THE PROCEDURE IS AS FOLLOWS:

5. Remove the thermometer and read the temperature.

6. Record the reading and dispose of the thermometer as appropriate.
 PROCEDURES OF MEASURING BODY
TEMPERATURE

TAKING A RECTAL TEMPERATURE

The rectal site is considered to provide the most reliable measurement of
body temperature because factors that can alter the results are minimized.
Body temperature should not be measured rectally if the patient is restless
or has rectalpathology such as tumors or hemorrhoids.

To take a rectal temperature, use a thermometer with a blunt tip. Never use
an oral thermometer to take a rectal temperature. Probe covers are often
colored red for rectal temperature.
 PROCEDURES OF MEASURING BODY
TEMPERATURE

THE PROCEDURE IS AS FOLLOWS:

1. Obtain the correct thermometer.
2. Put on clean gloves.
3. Assure the patient’s privacy and place him or her in the Sim’s position.
4. Expose only as much of the patient as necessary for clear viewing of the
rectal area.
5. Lubricate the thermometer tip (or probe cover if one is used) with
lubricating gel
 PROCEDURES OF MEASURING BODY
TEMPERATURE

THE PROCEDURE IS AS FOLLOWS:

6. Separate the patient’s buttocks with the heel of one
hand so that rectum is clearly visible.
7. Gently insert the tip of the thermometer into the rectum about 1 to 1.5
inches and hold it in place for 2 to 3 minutes. Do not leave a patient with a
rectal thermometer in place. It must be held in place for an accurate
reading.
8. Remove the thermometer, read it, and dispose of it as appropriate.
 PROCEDURES OF MEASURING BODY
TEMPERATURE

THE PROCEDURE IS AS FOLLOWS:

9. After removing the gloves in the correct manner and performing a

minimum 30-second hand wash, record the temperature.
VITAL SIGNS:
PULSE
PULSE
As the heart beats, blood is pumped in a pulsating
fashion into the arteries. This results in a throb, or
pulsation, of the artery. At areas of the body in which
arteries are superficial, the pulse can be felt by holding
the artery beneath the skin against a solid surface such
as bone.
 THE PULSE CAN BE DETECTED MOST
EASILY IN THE FOLLOWING
AREAS OF THE BODY:

Apical pulse: Radial pulse: over Carotid pulse:

Femoral pulse: Popliteal pulse:
over the apex of the radial artery over the carotid
over the femoral at the posterior
the heart (heard at the wrists artery at the
at the base of
artery in the surface of the
with a front of the
the thumb groin knee
stethoscope) neck
 THE PULSE CAN BE DETECTED MOST
EASILY IN THE FOLLOWING
AREAS OF THE BODY:

Dorsalis pedis pulse Brachial pulse: in the

Temporal pulse: (pedal): at the top of the
Posterior tibial groove between the
over the feet in line with the
biceps
groove between the pulse: on the
temporal artery and triceps muscles
extensor inner side of the above the elbow at
in tendons of the great
and second toe (may be ankles the antecubital
front of the ear congenitally absent) fossa
PULSE
the pulse rate is rapid if the blood pressure is low and slower if the blood
pressure is high.

The normal average pulse rate in an adult man or woman in a resting

state is between 60 and 90 beats/min.

The normal average pulse rate for an infant is 120 beats/min.

A child from 4 to 10 years of age has a normal average pulse rate of 90 to

100 beats/min.
PULSE

The heart rate is measured in beats per minute (BPM).

Tachycardia (abnormally rapid pulse) occurs when the heart

rate is greater than 100 BPM. This may be temporary, as a
result of exertion, nervousness, or excitability, but can also be
caused by a damaged heart.
HOW TO LOCATE THE PULSE
Place your fingers over the artery with your thumb on the
back of the wrist and compress gently but firmly.
By compressing the artery against the radius, the pulse is
easy to feel, especially if the patient's wrist is held palm
down.
When the radial pulse rate is taken routinely, it is common
to count for 15 seconds and then multiply the result by 4.
Whenever there is an irregular rate or rhythm, count for a
full 60 seconds.
 ASSESSMENT OF THE
PULSE
If a registered nurse is not present to take the pulse rate, be prepared
to make this assessment before beginning any invasive diagnostic
imaging procedure in order to establish a baseline reading and to
reassess it frequently until the procedure is complete and the patient
leaves the department.

The radial pulse is usually the most accessible and can be taken
most conveniently on an adult patient.
The apical pulse is used to monitor if the radial pulse is
inaccessble. Listening through a stethoscope.
ASSESSMENT OF THE
PULSE

For infants and children, the apical pulse is the most accurate for
cardiovascular assessment.
The femoral, popliteal, and pedal pulses are assessed bilaterally if
peripheral blood flow is to be assessed
 ASSESSMENT OF THE
PULSE
When assessing pulse rate, report the strength and regularity of the
beat as well as the number of beats per minute.

Radiographer must know:

The normal rhythm of the pulse beat is regular, with equal time
intervals between beats.
If the beat is irregular, unusually rapid, unusually slow, or unusually
weak, immediately report this to the physician in charge of the
patient.
Changes in pulse rate duringa procedure must also be reported
 ASSESSMENT OF THE
PULSE
Equipment need: For monitoring the apical
pulse:
watch with a second hand
and a pad and pencil to a stethoscope that has been
record the findings cleaned will be needed.

CALL OUT! CALL OUT!

DO NOT USE THE THUMB TO COUNT THE BE CAREFUL NOT TO PRESS TOO HARD WITH

PULSE BECAUSE IT HAS ITS OWN PULSE. THE FINGER OR THE

PULSE WILL BE COMPRESSED AND NOT FELT.
RESPIRATOR RATE The function of the Respiratory system is
to exchange oxygen and carbon dioxide
The average rate of respiration (one inspiration and between the external environment and
one expiration) for an adult man or woman is 15 to the blood circulating in the body.
20 breath/min, and for an infant it is 30 to 60
breath/min.
Respiration of fewer than 10 breaths/min for an adult may result in
CYNOSIS. When a patient is using more than the normal effort to
breath, he or she is described as dyspneic or as having DYSPNEA.

BRADYPNEA - Slow breathing with fewer than 12 breaths per

minute .
TACHYPNEA - Rapid breathing in excess 20 breaths per minute .

To count respirations, simply note the number of inhalation per

minute. This is often done while continuing to hold the wrist after the
pulse has been counted, since some patients may force a change in
the respiratory rate if aware that a count is being made.
ASSESSMENT OF RESPIRATION
As with other vital signs, it is important to establish a baseline respiratory rate because
changes in respiration are often an early sign of threatened physiologic state.

REMEMBER, That the rate of respiration increases with:

Respiration is also
quicker in
newborns and
infants.
Physical Exercise Emotion

When assessing respiration, observe the rate, depth, quality, and pattern.
ASSESSMENT OF RESPIRATION
The assessment procedure is as follows:

Keep the patient in a seated or supine.

Observe the chest wall for symmmetry of movement .
observe skin color
Count the number of times the patient's chest rises and
falls for 1 minute.
If a patient complains of dyspnea ( difficult of breathing ), or exhibits an abnormal respiratory
rate , you should inform the radiologist and prepare oxygen equipment for immediate use if
ordered.

Remember: When recording respiration, use the abbreviation R. R 20 equals 20 rises and falls of
the chest wall. Any abnormalities or deviation from the baseline should be reported tro the
physician in charge of of the patient and recorded, for example, R28, shallow and labored.
BLOOD PRESSURE
Pressure is defined as the product of flow times resistance.
Blood Pressure is the amount of blood flow ejected from
the left ventricle of the heart during systole and amount of
resistance the blood meets due to systemic vascular
resistance.

Blood pressure normally varies with :

Age
Gender
Physical development
Body posotion
Time of day
Health status
BLOOD PRESSURE
Blood pressure is usually lower in the morning after a night of sleep than later in
the day after activity.
Blood pressure increases after a large intake of food. Emotions and strenuous
activity usually cause systolic blood pressure to increase.
HYPERTENSION (Abnormally high blood pressure)
Hypertension is more common in men before the age of 50 and in
women after age of 50. In aging population, the incidence of
hypertension gradually increase until approximately 30% of
individuals will show some elevation above normal.

HYPOTENSION(Abnormally low blood pressure)

Hypotension can result in a potentially life threatening condition
called SHOCK.
EQUIPMENT NEEDED TO MEASURE BLOOD
PRESSURE
The Instrument used to measure blood pressure SPHYMOMANOMETER (equipment
using stethoscope and blood pressure cuff).

Two numbers, read in millimeters of mercury (mm Hg), are recorded when reporting blood
pressure : Systolic pressure and Diastolic pressure.
The SYSTOLIC reading is the highest point reached during contraction of the left
ventricle of the heart as it pumps blood into the aorta.
The DIASTOLIC pressure is the lowest point to which the pressure drops during
relaxation of the ventricles and indicates the minimal pressure exerted against the
arterial wall continuously.

In men and women, the normal ranges are 90 to 120 mm Hg for systolic pressure and 50 to
70 mm Hg for diastolic pressure. Adolescent patients' blood pressure ranges from 85 to 130
mm Hg systolic and 45 to 85 mm Hg diastolic.
EQUIPMENT NEEDED TO MEASURE BLOOD
PRESSURE

Mercury manometer Aneroid manometer Electronic

EQUIPMENT NEEDED TO MEASURE BLOOD
PRESSURE
There are three types of sphygmomanometers, a mercury manometer, Aneroid
manometer and Electronic.

The Mercury manometer is more accurate of the two but it is less convenient to use.
traditional mercury-gravity instrument have been phased out in response to the OSHA.
The Aneroid manometer needle should point to zero before the bladder of cuff is
inflated. Aneroid manometer are the type most often found in the radiology
department., because this procedure is most frequently used in an emergency, it is
important to be proficient before the need arises.
An Automated vital sign monitor is uses during special diagnostic imaging procedures
when it is necessary to know the patient's circulatory status at all times. The pulse,,
blood pressure and mean arterial pressure are measured with this instrument.
MEASURING
BLOOD
PRESSURE
LOCATION ON MEASURING BLOOD PRESSURE
NORMAL VALUES
THANK
YOU!