Introduction
At what stage of patient assessment are vital signs typically taken?
Secondary assessment
What is respiration?
It is the process of taking in oxygen and expelling carbon dioxide.
What is pulse?
Pulse is the pressure wave of blood that surges through an artery as the heart contracts.
What is blood pressure?
Blood pressure measures the force of the blood against the artery walls when the heart contracts and relaxes.
During patient assessment, what signs can the skin provide?
Skin color, temperature, moisture and capillary refill can all reflect the status of the heart, circulation and respiration.
What are baseline vital signs?
Baseline vital signs are the first set of vital sign measurements taken during patient assessment.
How is it counted and assessed?
One respiration is counted as a breath in and out. It is assessed by rate, rhythm and quality.
What are common pulse sites?
Temporal, carotid, brachial, radial, femoral, popliteal, posterior tibial, and dorsalis pedis (pedal) are common pulse sites.
What does blood pressure indicate in a patient?
Blood pressure reflects the condition of the heart, blood vessels, and volume of blood in the body.
Where on a patient’s skin should an EMS provider look?
Inside of lower eyelid, inside of the cheek, and nail beds should be checked for color. Palms of the hand and soles of the feet should be checked for pink color in infants, children and people of color.
What can a series of vital signs measurements show?
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What is respiratory rate and how can it be counted?
Respiration rate is the number of times a patient breathes per minute. Breathing can be counted for 30 seconds, then multiplied by two, or counted for 15 seconds and multiplied by four.
Describe the three ways pulse is assessed.
Rate – number of beats per minute
Rhythm – pattern of beats; regular or irregular
Quality (volume) – strength of beats; strong, weak, thready or bounding
What two readings are taken for blood pressure?
Systolic and diastolic
Describe abnormal skin colors and what they might mean.
Cyanotic: bluish color can indicate low oxygen levels and problems with respiration, ventilation, or the airway
Flushed: redness of the face can indicate carbon monoxide poisoning or exposure to extreme heat
Jaundiced: yellowing of the skin and whites of the eyes can indicate liver abnormalities
Pale: white skin can indicate hypoglycemia, hypoperfusion or blood loss
What is the minimum number of times vital signs should be taken before a patient reaches the hospital?
Two
What are normal respiratory rates by age group?
Adults: 12–20 breaths per minute
Children: 15–30 breaths per minute
Infants: 25–50 breaths per minute
Newborns: 30–60 breaths per minute
What are average pulse rates by age group?
Adults: 60–100 beats per minute
Children over seven: 70–90
Children one to seven: 80–110
Infants: 100–160
How is pulse pressure calculated?
It is the difference between systolic and diastolic pressures.
How should you assess a patient’s skin temperature and moisture?
Pull your examination glove aside and feel the patient’s skin with the back of your hand.
How frequently should vital signs be taken for a stable patient versus an unstable patient?
Stable patients, every 15 minutes; unstable patients, every five minutes
How is respiratory rhythm classified?
Regular, with equal spacing of breaths
Irregular, with unequal spacing of breaths
What are some things that can cause abnormalities in pulse?
Increased pulse: stimulant drugs, excitement, fever, shock and nervous tension
Decreased pulse: sleep, depressant drugs, heart disease, coma and physical training
What are normal ranges for blood pressure by age group?
Adults: systolic 100–120 mm Hg; diastolic 60–80 mm Hg
Children: systolic 80–100 mm Hg; diastolic two-thirds of systolic
How can skin temperature and moisture be classified?
Normal, cold, cool, warm, hot, clammy, dry, diaphoretic (sweaty)