Vital signs 1 Outlines Pulse Respiration Temperature Blood

Vital signs 1

Outlines �Pulse �Respiration �Temperature �Blood �Pupils pressure �Colors �Level of consciousness �Reaction to pain �Ability to move A-2

I - Pulse �Reflects the rate of heart beats. �Felt when an artery passes over a bone. near body surface. �Pulse check on both arms. �Feel for: force and rhythm. A-3

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Commonest sites used 1 - Radial: artery of the wrist, below the thumb. 2 - Carotid: in groove created by windpipe and large muscle in the neck. Commonly used in CPR. 3 - Temporal: in front of the ear. 4 – Femoral: near the groin. 5 – Brachial: located on the inside of upper arm. Used in infant during CPR. 6– Dorsalis pedis: over the dorsum of the foot. A-5

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Pulse Points � Carotid Brachial Radial Femoral Popliteal Temple College EMS Program 7

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Pulse Points � Dorsalis Pedis Posterior Tibia (Posterior and slightly inferior to medial Malleolus) Temple College EMS Program 9

Heart rate � Normal heart rate: 60 – 100/ minute. � Regular in rate and rhythm, strong to touch. � Tachycardia: Fast heart rate > 100/minute. � Causes: exercise, infection, excitement, shock, heart attack. � Bradycardia: Slow heart rate < 60/minute. � Causes: sleep, rest, overdose of certain drugs, hypoxia. A 10

� Normal II - Respiration respiratory rate is 12 – 16 /minute. � Tidal volume ( air breathed in ) is 500 ml � Hyperventilation: increased respiratory rate. � Occurs during exercise, infection, emotional stress, shock. � Hypoventilation: decreased respiratory rate. � Occurs during sleep, overdose of certain drugs. � Apnoea: cessation of breathing. A 11

�Average III - Temperature body temperatures is 37 C. �Hypothermia: low temperature �Occurs in severe loss of body fluids through excessive vomiting, diarrhea, bleeding, shock. Hyperthermia: high temperature �Occurs as a result of infection, heat illness, injuries. � A 12

Sites of temperature measurement �Mouth: for one minute �Axilla: for four minutes. �Rectally: for two minutes. �Skin: using a special scale or feeling by the hand. A 13

IV – Blood pressure �Definition: pressure (force) exerted on the wall of the artery by the blood. A 14

�Systolic: Blood pressure the force to pump blood out of the heart. �Diastolic: resting period when pressure falls. �Normal blood pressure: � 120/80 – 100/70. A 15

�Hypertension: high blood pressure. �Occurs in atherosclerosis, obesity, increasing age, exercise. �Hypotension: low blood pressure. �Occurs in fluid loss in vomiting, diarrhea, shock, bleeding. A 16

Measurement of blood pressure �Place the patient in a position of comfort. �Support the bared arm, avoid constriction of arm. �Apply the cuff firmly. �Cuff should be approximately 2. 5 cm above antecubital fossa. A 17

sphygmomanometer, a device used for measuring arterial pressure(MERCURY) Stethoscope. Cuff. A 18

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five phases of Korotkoff sounds A 24

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V – Pupils � Examine both eyes. � Check pupils for size, equality and responsiveness � Normal: equal, and reactive to light. � Constricted unresponsive: CNS disease, narcotics e. g. heroin, morphine. � Dilated unresponsive: Cardiac arrest. Unequal: in stroke, head injury.

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VI – Colors of skin and mucous membranes �Normal healthy flushing after pressing for few seconds on skin, ear lobes, tip of fingers. �Pale skin: in severe bleeding, shock, hypotension. �Cyanosis (blue ): due to hypoxia, airway obstruction, heart failure. �Pink coloration: carbon monoxide poisoning. �Yellow coloration (jaundice): in hepatitis, hemolytic anemia, obstructive jaundice. A 29

VII – Level of consciousness Used to assess responsiveness during: �Cardiac arrest, �Head injuries, �Comatose patients A 30

VIII – Reaction to pain Response can be tested by: � 1 -Pinching the earlobe � 2 -Pressing over the eye brow � 3 -Rubbing the sternum � 4 -Using a pin or sharp object. A 31

IX – Ability to move Assessed if the patient is conscious, with no evidence of injury to extremities, and suspected spinal injury. Both sides are tested. �Upper extremities Ask patient to grasp your hand. �Lower extremities Ask patient to press sole of his foot against your hand. A 32

Thank you 33