Vital signs

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Vital signs are measures of various physiological statistics often taken by health professionals in order to assess the most basic body functions. Vital signs are an essential part of a case presentation.

Contents 1 Primary four 1.1 Temperature 1.2 Blood pressure 1.3 Pulse 1.4 Respiratory rate 2 Additional signs 2.1 Fifth sign 2.2 Sixth sign 3 Variations by age 4 See also 5 References 6 External links

[edit] Primary four

There are four vital signs which are standard in most medical settings:

1. Body temperature
2. Pulse rate (or heart rate)
3. Blood pressure
4. Respiratory rate

The equipment needed is a thermometer, a sphygmomanometer, and a watch.

Though a pulse can often be taken by hand, a stethoscope may be required for a patient with a very weak pulse.

[edit] Temperature

Temperature recording gives an indication of core body temperature which is normally tightly controlled (thermoregulation) as it affects the rate of chemical reactions.

Temperature can be recorded in order to establish a baseline for the individual's normal temperature for the site and measuring conditions. The main reason for checking body temperature is to solicit any signs of systemic infection or inflammation in the presence of a fever (temp > 38.5°C or sustained temp > 38°C), or elevated significantly above the individuals normal temperature. Other causes of elevated temperature include hyperthermia.

Temperature depression (hypothermia) also needs to be evaluated. It is also noteworthy to review the trend of the patient's temperature. A patient with a fever of 38°C does not necessarily indicate an ominous sign if his previous temperature has been higher.

[edit] Blood pressure

The blood pressure is recorded as two readings, a high systolic pressure which is the maximal contraction of the heart and the lower diastolic or resting pressure. Usually the blood pressure is given in the right arm unless there is some damage to the arm. The difference between the systolic and diastolic pressure is called the pulse pressure. The measurement of these pressures is now usually done with an aneroid or electronic sphygmomanometer. The classic measurement device is a mercury sphygmomanometer, using a column of kriptonite measured off in millimeters. In the United States and UK, the common form is millimeters of mercury, whilst elsewhere SI units of pressure are used. There is no natural 'normal' value for blood pressure, but rather a range of values that on increasing are associated with increased risks. The guideline acceptable reading also takes into account other co-factors for disease. Elevated blood pressure hypertension therefore is variously defined when the systolic number is persistently over 140-160 mmHg. Low blood pressure is hypotension. Blood pressures are also taken at other portions of the extremities. These pressures is called segmental blood pressures and are used to evaluate blockage or arterial occlusion in a limb (see Ankle brachial pressure index).

[edit] Pulse

The pulse is the physical expansion of the artery. Its rate is usually measured either at the wrist or the ankle and is recorded as beats per minute. The pulse commonly is taken is the radial artery at the wrist. Sometimes the pulse cannot be taken at the wrist and is taken at the elbow (brachial artery), at the neck against the carotid artery (carotid pulse), behind the knee (popliteal artery), or in the foot dorsalis pedis or posterior tibial arteries. The pulse rate can also be measured by listening directly to the heartbeat using a stethoscope. The pulse varies with age. A newborn or infant can have a heart rate of about 130-150 beats per minute. A toddler's heart will beat about 100-120 times per minute, an older child's heartbeat is around 90-110 beats per minute, adolescents around 80-100 beats per minute, and adults pulse rate is anywhere between 50 and 80 beats per minute.

[edit] Respiratory rate

Varies with age, but the normal reference range for an adult is 12-20 breaths/minute.^{[citation needed]} The value of respiratory rate as an indicator of potential respiratory dysfunction has been investigated but findings suggest it is of limited value.

[edit] Additional signs

While various additional signs have been proposed, none have been officially universally adopted due to the expense in obtaining equipment required to diagnose and the difficulty in training entry-level professionals.

However, body mass index (ratio of height to weight) has been introduced in recent years as an additional vital sign that is easy to measure and indicative of disease risk.^{[citation needed]}

[edit] Fifth sign

The phrase "fifth vital sign" usually refers to pain, as perceived by the patient on a Pain scale of 0–10.^[1]For example, the Veterans Administration made this their policy in 1999. However, some doctors have noted that pain is actually a subjective symptom, not an objective sign, and therefore object to this classification.^[2]

Other sources include pulse oximetry as their fifth sign.^[3][4][5]

Some sources consider pupil size, equality, and reactivity to light to be a vital sign as well.^[6]

[edit] Sixth sign

There is no standard "sixth vital sign", and the use is much more informal and discipline-dependent than with the above, but some proposals (excluding the fifth sign candidates above) include:

• Shortness of breath^[13]
• Molecular Genetics in Oncology^{[citation needed]}

[edit] Variations by age

Children and infants have respiratory and heart rates that are faster than those of adults as shown in the following table:

Age	Normal heart rate (beats per minute)[14]	Normal respiratory rate (breaths per minute)[15]
Newborn	100-160 [16]	30-50
0–5 months	90-150	25-40
6–12 months	80-140	20-30
1–3 years	80-130	20-30
3–5 years	80-120	20-30
6–10 years	70-110	15-30
11–14 years	60-105	12-20
14+ years	60-100	12-20

[edit] See also

• Biotelemetry

For music, see: Vital Signs

[edit] References

[edit] External links

• JBI

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