Vital Signs

Dono Indarto,dr., MBiotechSt.AIFM

 Pendahuluan
Definisi: pengukuran suhu, frekuensi
pernapasan, denyut nadi dan tekanan
darah.
Informasi penting status kesehatan
penderita.
Namun tanda-tanda vital dbn tidak
menjamin status fisiologisnya juga dbn.
Lebih tepat sebagai observasi klinik yg
diikuti pmx lain= status klinis penderita.
 Pengukuran suhu
Ada 3 tempat yang umum dilakukan:
sublingual, aksilla dan rektal.
Sublingual: sakus sublingual posterior
sinistra atau dekstra.
Hasil akurat 15-20 menit setelah makan
dan minum.
6 menit pembacaan untuk membedakan
febris dan afebris.
Tabel 1. Pengukuran suhu

The different body areas that A wide range of instruments

have been used for the have been used to measure
measurement of body these temperatures, and
temperature include: include:

mouth glass mercury

axilla thermometer
tympanic membrane electronic thermometer
rectum pulmonary artery catheter
skin surface endotracheal tube with
pulmonary artery temperature probe
nose urinary catheter with
groin temperature probe
oesophagus liquid crystal thermometer
trachea strip
urinary bladder disposable thermometers
urine infrared (tympanic)
thermometers
 Pengukuran suhu (cont)
Peraksilla: hasil bervariasi antar individu.
Rectal temperatures, which most closely
reflect internal or core values, are
approximately 1 degree F higher than
those obtained orally.
Temperature is measured in either Celcius
or Farenheit, with a fever defined as
greater than 38-38.5 C or 101-101.5 F.
 Frekuensi pernapasan
Respirations are recorded as breaths per minute.
They should be counted for at least 30 seconds
as the total number of breaths.
This can be done by observing the rise and fall of
the patient's hospital gown while you appear to be
taking their pulse.
Normal is between 12 and 20.
It can be a very reliable marker of disease activity
in the setting of cardio-pulmonary illness.
 Denyut nadi
This can be measured at any place where there is a
large artery (e.g. carotid, femoral, or simply by listening
over the heart), though for the sake of convenience it is
generally done by palpating the radial impulse.
Place the tips of your index and middle fingers just
proximal to the patients wrist on the thumb side,
orienting them so that they are both over the length of
the vessel.
You may find it helpful to feel both radial arteries
simultaneously, doubling the sensory input and helping
to insure the accuracy of your measurements.
 Tekanan darah
Blood pressure (BP) is measured using mercury
based manometers, with readings reported in
millimeters of mercury (mm Hg).
The inflatable bladder, which can be felt through
the vinyl covering of the cuff, should reach
roughly 80% around the circumference of the
arm while its width should cover roughly 40%.
If it is too small, the readings will be artificially
elevated. The opposite occurs if the cuff is too
large.
 Korotkoff's Sounds
Measurement of blood pressure by auscultation is based on the
sounds produced as a result of changes in blood flow, termed
Korotkoff's sounds, and are:
1. Phase I The pressure level at which the first faint, clear tapping
sounds are heard, which increase as the cuff is deflated (reference
point for systolic BP).
2. Phase II During cuff deflation when a murmur or swishing sounds
are heard.
3. Phase III The period during which sounds are crisper and increase in
intensity.
4. Phase IV When a distinct, abrupt, muffling of sound is heard
5. Phase V The pressure level when the last sound is heard (reference
point for diastolic BP).
 Recommended Blood Pressure
Measurement Technique
Patient should be seated and have rested for 5 minutes and have
arm supported at heart level.
Appropriate cuff size should be used, and the bladder should nearly
(at least 80%) or completely encircle arm.
Patients should not have smoked or ingested caffeine within 30
minutes before measurements.
Measurements should be taken with a mercury
sphygmomanometer, a recently calibrated aneroid manometer, or a
calibrated electronic device.
Both systolic and diastolic blood pressure should be recorded.
Korotkoff's phase V (disappearance of sound) should be used for
the diastolic reading.
Two or more readings, separated by 2 minutes, should be averaged,
and more taken if they differ by more than 5mmHg.