VITAL SIGNS

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VITAL SIGNS

• BLOOD PRESSURE
• PULSE
• TEMPERATURE
• RESPIRATIONS

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WHY MEASURE VITAL SIGNS?

• REFLECTIVE OF THE HEALTH STATUS OF AN INDIVIDUAL
• EASILY OBTAINABLE

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BLOOD PRESSURE

• 1 in 3 Americans have high blood pressure
• 31.6 of persons that have high blood pressure
  are unaware that they have it
• High blood pressure(hypertension) significantly
  increases the risk for heart disease and stroke

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What is Blood Pressure?

• Blood pressure is the force in the arteries when
  the heart beats(systolic), and when the heart is
  at rest(diastolic)
• Blood pressure is measured in millimeters of
  mercury(mmHg)

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HEART FUNCTION IN BP
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NORMAL BLOOD PRESSURE
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HYPERTENSION

• PERSISTENTLY ELEVATED BLOOD PRESSURE CURRENT
  STANDARDS gt 140/90

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METHODS FOR OBTAINING A BLOOD PRESSURE

• DIRECT Direct intra-arterial measurement with a
  catheter
• INDIRECT Compression of the brachial artery
  using a sphygmomanometer(blood pressure cuff)

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INDIRECT METHOD OF OBTAINING A BLOOD PRESSURE

• Introduced in 1896 by Riva Rocci
• The method involves occluding the brachial artery
  and listening for audible sounds
• These sounds are called Korotkoff sounds named
  after the Russian physician that described them

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• Systolic Pressure at which the sounds first
  appear
• Diastolic Pressure at which the sounds are no
  longer audible

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EQUIPMENT FOR OBTAINING A BLOOD PRESSURE
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DEVICES FOR OBTAINING A BLOOD PRESSURE
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STETHOSCOPE
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PLACEMENT OF EAR PIECES
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METHOD FOR TAKING A BP
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SEAT THE PATIENT IN A COMFORTABLE POSITION
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SELECT THE APPROPRIATE SIZE CUFF

• Adult The bladder should encircle 80 of the
  arm
• Children The bladder should encircle 100 of
  the arm

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Palpate and locate the brachial artery
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Position the cuff so the bladder is over the
artery and the cuff is 1-2cm above the
antecubital fossa
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Position the cuff so you can see the manometer
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Inflate the BP cuff

• Inflate to 70 mm Hg and increase by 10 mm until
  the radial pulse disappears
• Note this level and inflate the cuff 20 -30 mm Hg
  more to overcome an ausculatory gap

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Recording the BP

• Place the stethoscope over the brachial artery
  just above the antecubital fossa
• Inflate the cuff slowly, then release the valve

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Record the systolic and diastolic readings

• First sounds heard will be the systolic
• Continue deflating the cuff until the last sound
  is heard the diastolic

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Measurement should be repeated after 30 seconds

• The blood pressure is the average of the two
  readings

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ERRORS IN TAKING BP

• Cuff too big BP too high
• Cuff over clothing inaccurate reading
• Stethoscope occluding ear distorted sound
• Stethoscope turned incorrectly no sound

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PULSE

• Palpate the radial artery
• Use the middle and index fingers(NO thumb)
• Count the pulses for 15, 30 seconds and X
• Count the pulses for 1 minute

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RESPIRATIONS

• Seat the patient in a quiet comfortable
  environment
• Count the number of times the chest rises and
  falls in 30 or 60 seconds
• Average number of respirations 12 20/minute
• Bradypnea Slower that 12/minute
• Tachypnea - Persistent over 20/minute

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TEMPERATURE
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TEMPERATURE

• ORAL
• AXILLARY - LOWER
• RECTAL - HIGHER

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PRACTICE!!!!