SPM 100 Clinical Skills Lab 2 Emergency Assessment

SPM 100 Clinical Skills Lab 2 Emergency Assessment of Vital Signs and Pain Daryl P. Lofaso, M. Ed, RRT

Vital Signs (VS) n n n Temperature Pulse Respiration Blood Pressure Pain Assessment

General Guidelines When Assessing VS n n n Taken by person caring for patient. Know normal ranges Baseline data for patient n n i. e. patients norms Patient’s Diagnosis (Dx)

Body Temperature

Balance of Body Temperature

Temperature Conversion

Pulse (Heart Rate – HR) n Normal n n 60 -100/min. Abnormal n n < 60 - Bradycardia > 100 - Tachycardia

Arterial Pulse Points

Abnormal Pulse Characteristics n n n Weak Pulse – ↓ stroke volume Bounding Pulse - ↑ stroke volume Paradoxical Pulse – change with respirations

Respiratory Rate n n Normal relaxed breathing is effortless, automatic, regular and even. Normal range: n n n Adult : 12 -16/min. Child: 20 -30/min. Infant: 35 -40/min.

Respiratory Patterns

Blood Pressure n n n B/P = Systolic Pressure / Diastolic Pressure Systolic Pressure: max. pressure exerted on the arteries with the LV Diastolic Pressure: the elastic recoil pressure presented by the arterial walls

BP Formulas n Pulse Pressure = systolic pressure – diastolic pressure n n Normal: 30 -50 mm. Hg Mean Arterial Pressure = systolic pressure + 2(diastolic pressure) / 3 n Normal: 70 -100 mm. Hg

Shock Index (SI) n Define: the ratio of the heart rate to systolic blood pressure. n n n SI = HR (bpm) / Systolic B/P (mm. Hg) Normal range: 0. 5 – 0. 7 Elevated SI: > 0. 9 - critically ill (poor outcome) Sensitive indicator of Left Ventricular dysfunction Used in the Emergency Department (ED) and Intensive Care Unit (ICU)

Pain Assessment Range: Mild: 1 – 3 Moderate: 4 – 6 Severe Pain: 7 - 10

Pain Management n Non-Pharmacologic n n n Breathing - slowly and deeply Distraction Pharmacologic n Non-Narcotic Tylenol Ibuprofen n Narcotic Morphine

Hand Washing § GOOD HAND WASHING CAN PREVENT NOSOCOMIAL INFECTIONS § 35% OF NOSOCOMIAL INFECTIONS ARE PREVENTABLE!!!!

Professional Conduct n n Introduce yourself Explain the procedure / examination to the patient Ask the patient if they have any questions Cover the patient with a sheet. Only expose area examining while performing a procedure/examination