‫جامعة العين‬

‫كلية التقنيات الصحية والطبية‬

‫قسم التخدير‬

‫‪ICU Monitoring‬‬
‫‪Vital Signs Monitor‬‬
‫‪Part 1‬‬
 Vital Signs Monitor
❖ A vital signs monitor is a device that allows you to detect and continuously
display the physiological parameters of the patient.
❖ It also has an alarm system that alerts when there is an adverse situation or
outside the desired limits. In the event that any of them is below or above
normal for the patient’s age, or any other adverse activity is generated, an
alarm is activated. These alarms are visual and audible, although they can be
silenced easily.
❖ This device is manufactured either fixed or portable.
 Vital Signs
Vital signs are measurements of the body's most basic functions.
There are five basic parameters that record and show today’s vital signs monitors:
1- Basic Parameters:
• Electrocardiogram (ECG)
• Respiration (RESP)
• Temperature (TEMP)
• Non-invasive pressure (NIBP)
• Oxygen saturation (SpO2)
2- Other parameters:
• Invasive pressure (PI)
• Central Venous Pressure (CVP)
• Capnogram
 Electrocardiogram (ECG)
❖ Electrocardiogram (ECG) is used to record the electrical impulses of the
heart in a process called “electrocardiography” by using electrodes
placed on the skin to show ECG waveform.
❖ With the vital signs monitor, skin electrodes are either five or three color-
coded electrodes.
❖ The five electrodes are:
✓ Green electrode – left lower
✓ Yellow electrode – left upper
✓ Red electrode – right upper
✓ Black electrode – right lower
✓ White or Blue electrode – center
❖ ECG waveform consists of:
✓ P wave – represents atrial depolarization
✓ QRS complex – represents ventricular depolarization
✓ T wave – represents ventricular repolarization

❖ ECG is used to diagnose a lot of heart problems and

diseases
 Heart Rate (HR)
Heart rate is a rate of heart beat per minute (bpm).
HR > normal range: Tachycardia
HR < normal range: Bradycardia
HR = 0 bpm: Cardiac arrest

❖ In vital signs monitor, it is shown as a green number (commonly) in the

right upper corner in the monitor display. It is recorded by ECG electrodes.

❖ HR is affected by:
Age, weight, diseases, movement speed, anxiety, stress conditions, pain,
drugs, acid/base balance, low oxygen consumption, allergies reactions,
pregnancy,…etc.
 Non-invasive Blood Pressure (NIBP)
❖ Blood pressure (BP) can be defined as the pressure exerted by the
circulatory blood on the arterial walls. It provides an important reflection
of the blood flow when the heart is contracting (systole) and relaxing
(diastole).
❖ Four values are considered when measuring BP:
✓ Systolic Blood Pressure (SBP) – indicates the peak pressure attained during the cardiac
cycle.
✓ Diastolic Blood Pressure (DBP) – indicates the pressure attained by cardiac relaxation
(rest) between two beats.
✓ Mean Blood Pressure (MBP) – is the mean pressure during cardiac cycle.
Mean arterial pressure (MAP) = [SBP + (2 x DBP)]/3
❖ Normal blood Pressure for adult age groups:
✓ SBP: 100 – 140 mmHg
✓ DBP: 60 – 90 mmHg

❖ BP > Normal range: Hypertension

❖ BP < Normal range: Hypotension

❖ By using the vital signs monitor, you can

determine the NIBP by NIBP cuff which is
connected to the monitor by a cable and
then press NIBP Button in the monitor.

❖ You can set the monitor to repeat BP

measurement either auto (according to time
that you set it) or manual.
 Oxygen Saturation (SpO2)
❖ SpO2 means the ratio of arterial oxygen saturation in the peripheral blood vessels. It is
determined by a technique called “Pulse Oximetry” by using a device called “Pulse
Oximeter”
❖ Is a small, clip-like device placed on patient’s finger (commonly), ear lobe, or toe.
❖ In pulse oximetry, small beams of light pass through the blood in the patient finger,
measuring the amount of oxygen by measuring changes in light absorption in
oxygenated or deoxygenated blood.
❖ In the vital signs monitor, SpO2 is
measured by wired pulse oximeter which
is connected to the monitor by a cable.

❖ An SpO2 of 95-100% is considered

within normal ranges.
❖ SpO2 waveform is called “Plethysmography”.

❖ SpO2 readings are affected by low body temperature, low blood pressure,
some blood diseases (such as methemoglobinemia), presence of anything
that affects the passage of light beam through the blood such as nail
varnish, patient movement, and anything leads to interruption of blood
flow such as the cuff pressure,…etc.
 Respiratory Rate (RR)
❖ Respiratory rate Respiratory rate (RR) refers to the number of breaths as
calculated over one minute.
❖ RR is measured by breath per minute unit (bpm)
❖ Normal respiratory rate for adult is 12 – 16 bpm.
RR > normal range: Tachypnoea
RR < normal range: Bradycapnoea
No respiration: Apnoea
Difficulty in respiration: Dyspnoea

❖ In the vital signs monitor, respiratory rate is detected by the ECG electrodes and shown
on its display with respiratory waveform.
 Body Temperature
❖ Body temperature is represented by “the balance between heat produced
and heat lost (thermoregulation).

❖ The site where the temperature is measured can be affected by local

factors such as the oral temperature immediately after consumption of
hot/cold beverages.

❖ Normal Body temperature:

✓ Orally: 37°C ± 0.5°C
✓ Axillary: 36.5°C ± 0.5°C
✓ Rectally: 37°C + (0.5 – 0.8)°C.
✓ Body temperature > normal range: Hyperthermia
✓ Body temperature < normal range: Hypothermia

❖ You can measure body temperature quickly by special thermometers from

skin and ear lobes.

❖ In vital signs monitor, body temperature is measured by a small wired

body temperature sensor connected to the monitor by a shown on the
monitor display.