Vitals Basics
When taking a radial pulse, what two fingers do you use to feel the pulse, and why should you never use the thumb?
1. Index and middle fingers.
2. Thumb has its own pulse (you’ll measure your own heart rate).
What does bradypnea mean?
Slow + breathing
What is a normal resting pulse for an adult? (range)
60–100 beats per minute
What does AVPU stand for?
Alert, verbal, pain, unresponsive
What does SAMPLE stand for?
Signs and symptoms, allergies, medications, past medical history, last oral intake, and events prior.
What is one reason you might choose to check a carotid pulse instead of a radial pulse?
If the patient is unconscious or you can’t feel a radial pulse.
What is one reason the airway can become obstructed in an unconscious patient lying supine? Assume you just arrived (have not touched the patient yet).
Loss of muscle tone and gravity can cause the tongue to fall back and block the airway.
Hence why we do a head-tilt-chin-lift or jaw thrust.
What three skin characteristics are assessed when checking circulation as a vital sign?
Colour, temperature, and moisture. Ex: pink/warm/dry vs. pale/cool/clammy.
What two measurements/observations should you record when checking pupils with a pen light?
1. Size
2. Reactivity
Name three steps included in the Primary Survey.
1. LOR (AVPU)
2. ABS
3. Rapid body survey
4. Disposition
What are the three key features you must record when taking a pulse?
Rate (bpm), rhythm (regular/irregular), and strength (strong/weak).
Similar goes for measuring breathing.
How many breaths per minute is normal for an adult at rest?
12–20 breaths per minute
What is the most appropriate site to check a pulse in an unconscious adult?
Carotid artery
Rate this patient on the AVPU scale: Pt. does not track you when you approach, but reacts to your voice by opening their eyes and mumbling.
Verbal
What must you check before and after bandaging & splinting?
CSM (Capillary refill, sensory, motor)
You inflate the BP cuff until 140 mmHg, and then deflate. You start to hear sounds at 110 mmHg, which stop at 70 mmHg. What is the patient’s blood pressure?
110/70 mmHg
Unequal chest rise may indicate that one lung is not expanding properly. Name two conditions that could cause this.
Flair chest or pneumothorax
If you cannot hear Korotkoff sounds clearly (it is loud at a concert), what’s one alternative technique to measure BP? Does this measure systolic or diastolic BP?
Palpate the radial artery as you decrease the pressure in the cuff. Observed pressure of reappearance represents systolic BP.
What are the 3 categories of the GCS scale?
1. Eye opening
2. Verbal response
3. Motor response
A patient has a spinal injury, and you manually stabilize their head and place a collar. Does your partner have to continue holding manual stabilization?
Yes! A collar is an additional protection, but over protocol it does NOT mean you can stop manually stabilizing.
What should you do if you can’t hear Korotkoff sounds clearly due to background noise?
Systolic pressure through palpation
When providing assisted ventilations for an adult (pulse, but inadequate breathing), at what rate should you provide ventilations with a BVM?
One breath every 5-6 seconds
You find a patient with a present carotid pulse but no radial pulse. What is the systolic pressure less than given this?
Radial absent: Below 80 mmHg
A patient does not open their eyes, makes no verbal response, and shows decorticate posturing). What is their GCS scale?
Eye Opening: E1 (none)
Verbal Response: V1 (none)
Motor Response: M3 (flexion to pain / decorticate)
Total GCS = 5
List 2 vitals you are required to take before giving nitroglycerin (and the minimum for each).
1. BP (cannot be below 100 mmHg systolic)
2. Heart rate (cannot be below 50 bpm)