Vital Signs

Dr Nabil Sulaiman
 Objectives
z Performs the assessment of:
z Pulse

z Temperature
z BP

z Respiration
z Understand normal ranges of these
measurements
z Discuss pathological and non
pathological factors that influence these
measurements
 Format
z Presentation
z Video
z Practical
This lecture will cover:
Vital Signs
Pulse
Blood Pressure
Respiration
Temperature, and
z Oxygen Saturation
 Vital Signs
Why vital?
Provide critical information about the
patient’s state of health especially when ill
or recovering after procedure.
Can identify acute medical problem
Quantify the magnitude of illness and
how well the body is coping
Marker of chronic disease states
 Ideally
Warm room
Patients with gown and briefs
Curtain for privacy
Usually sitting position
 Temperature
Thermometer
z Electronic/ digital
z Mercury sterilized using 70% alcohol for 10 minutes or
plastic cover and clean with alcohol swab before reuse
Measured in:
z Mouth (Oral) under tongue
z Ear using disposable ear piece
z Axilla
z Rectal
z Skin
Normal oral temp is 37° C
z Higher in rectum 37.5° C
z Lower in axilla (0.5 ° C)
z Diurnal (day and night) variation
z Variation across menstrual cycle in women
 Respiration
Check:
z Rate average 14 (12-20) per minute
z Symmetry
z Depth
z Regularity
Types: more thoracic in women and more
abdominal in men
How: count the respiration while taking the
pulse
 Pulse
Palpate the radial pulse, proximal to the wrist
joint and medial to the radius on the thumb
side. What are you palpating arterial or
venous pulses and why?

Now describe the pulse you are feeling:

z Rate: count for 30 sec X 2 or 15 sec X4
z Rhythm: regular or irregular
z Volume: small or large
 Pulse
Other pulses you may palpate:
z Carotid artery
z Brachial artery
z Popliteal artery
z Posterior tibial artery
z Dorsalis pedis artery
 Pulse
Now examine the radial pulse in three
subjects:
z At rest, check both right and left pulse
simultaneously
z During inspiration and expiration and
compare
z Exercise

while examining the pulse check

respiratory rate
 Blood Pressure (BP)
Screening patients for hypertension
Monitoring antenatal care
Monitoring cardiac output:
z Surgery
z C.V. collapse such as hemorrhage

z Stroke

z Heart attack
 BP- What
Sphygmomanometer measures arterial
BP indirectly by detecting pulsations in
the brachial artery heard as sounds in
the stethoscope or can be imparted to
the air in the bag and cause oscilliations
in the manometer
z Systolic BP (highest)
z Diastolic BP (lowest)
 BP- How?
Check size of the cuff
Inflate cuff to occlude the blood flow
Gradually deflated and the first sound
(Koratkoff sounds) is systolic BP (~120 mm
Hg), oscilliations starts in the manometer
Keep deflating, when the sound disappear it
is the diastolic BP (~80 mm Hg)
Use palpation method (radial) and
auscultation (brachial) using stethoscope
Normal 120/80 (range 100/60 to 140/90).
 Oxygen Saturation?
Non-invasive measurement of gas
exchange and RBC blood carrying
capacity
Provides important information on
cardiopulmonary dysfunction.
Considered by many to be the fifth vital
sign
Video Demonstration
then
Practical in Clinical
Skills Lab upstairs