Saturday , December 15 2018
Vital Signs Vital Parameters

How to Check Vital Signs

Vital signs are the evidence of the current physical functioning of the body. They provide critical information that is ‘vital’ for life, and so they are called vital signs. In an emergency, the patient’s heart rate is the first vital sign checked by the healthcare worker.

Signs that show the condition of someone’s health, such as bodytemperature, rate of breathing, and heartbeat

Temperature

The degree of heat in a living body, normally about 98.6°F (37°C) in humans. The excess of this above the normal.  It is measured by a thermometer. Temperature is measured with a thermometer which coverts the readings into degrees on a temperature scale (commonly Fahrenheit or Celsius).
The Celsius scale (°C) is used for common temperature measurements in most of the world. It is an empirical scale. 

Measuring temperature of the body using a clinical thermometer.

 Pulse

The rhythmical throbbing of arteries produced by the regular contractions of the heart, especially as palpated at the wrist or in the neck. . The rhythmic contraction and expansion of an artery at each beat of the heart, often discernible to the touch at points such as the wrists

Checking pulse rate, rhythm, volume, etc. for assessing circulatory status.

 Respiration

The process of inhaling and exhaling of air. Respiration is taking a breath or the act of breathing.
Monitoring respiration and expiration in a patient.

the metabolic processes whereby certain organisms obtain energy from organic molecules; processes that take place in the cells and tissues during which energy is released and carbon dioxide is produced and absorbed by the blood to be transported to the lungs

Blood Pressure

Blood pressure (BP) is the pressure exerted by circulating blood upon the walls of blood vessels. When used without further specification, “blood pressure” usually refers to the arterial pressure in the systemic circulation.

Systolic Blood Pressure

The top number, which is also the higher of the two numbers, measures the pressure in the arteries when the heart beats (when the heart muscle contracts).

Diastolic Blood Pressure

The bottom number, which is also the lower of the two numbers, measures the pressure in the arteries between heartbeats (when the heart muscle is resting between beats and refilling with blood).

Measuring blood pressure using a sphygmomanometer.

Why Vital Signs are Important

To assess the general health status and any alteration in health status of patients.

Procedure

Collect the following articles at the bedside

  • Clinical thermometer either oral / rectal / axillary.
  • Container with freshly prepared wet swabs.
  • Container of dry cotton swabs.
  • Medium sized kidney tray.
  • Container with clean water swabs.
  • Recording sheet.
  • Watch with second hand.
  • Lubricant in case of rectal thermometer.
  • BP Apparatus.
  • Stethoscope

 Temperature

  • Check with patient if he has eaten / drunk within 15 minutes prior to recording his temperature.
  • Wipe thermometer with wet swab.
  • Shake thermometer and ensure the mercury level reaches the lowest marking on scale.
  • Place bulb of thermometer in patient’s mouth under the tongue posteriorly and ask patient to hold lips closed [If Consultant Order]. Alternatively, it can be placed in axilla after wiping axilla with a dry towel.
  • Leave thermometer in place for minimum three minutes.
  • Observe pulse and respiration.
  • Remove thermometer from mouth and wipe with wet swab in a rotatory manner from stem towards the bulb. OR
  • Remove thermometer from axilla and wipe with disinfectant swab in a rotatory manner from stem towards the bulb.
  • Read and record temperature.
  • Shake thermometer down until the mercury level falls to the lowest level.

Pulse

  • Ensure the patient is in a comfortable, relaxed position.
  • Palpate whichever peripheral artery is being used to record the pulse (commonly used artery is radial artery).
  • Place the middle three fingertips along the appropriate artery and press gently.
  • The pulse should be counted for 60 seconds.
  • Record the pulse rate.

Respiration

  • Whilst observing the respiration continues to hold the patient’s wrist as if taking the pulse. Do not explain to patient that you are recording respiration.
  • Ensure the patient is in a comfortable position.
  • Observe movement of the chest wall.
  • Evaluate the sounds made when the patient breathes.
  • Count the chest movements for 60 seconds. One inhalation and exhalation together count as one respiration.
  • Record the number of respiration.

Blood Pressure Checking

  • Explain to the patient that his blood pressure is going to be taken.
  • Measure the blood pressure under the same conditions each time.
  • Ensure that the patient is in the desired position i.e. lying, standing or sitting.
  • Use the correct size of blood pressure cuff.
  • Place the chest-piece of the stethoscope over the artery.
  • Apply the cuff of the Blood Pressure apparatus to the arm above the anticubital fossa or to the leg above the popliteal fossa, the extremity should be positioned for maximum patient comfort and examiner accessibility. The leg should only be used if both arms are inaccessible.
  • Inflate the cuff to a point approximately 20-30 mm of Hg above the last recorded reading or until the pulse can no longer be heard or palpated. Release the pressure valve on the cuff slowly.
  • Record the systolic and diastolic pressures and compare the present reading with previous readings.
  • Remove the equipment and clean it after use. The earpieces and chest-piece of the stethoscope should be wiped with a disinfectant  swab, in case if the patient is a known infected case.
  • The blood pressure should be washed periodically as well as cleaned with disinfectant in case of known skin infected cases.