Vital Signs

VITAL SIGNS
©2005 www.suspensiontrauma.info
What are “Signs”?
• Sign – Objective, measurable
• Symptom – Subjective, evaluated by the

patient
( Chest Pain, Difficulties Breathing , Headache )
Signs
Fever
• Normal temperature 36-37.5 degrees
Celsius
( 96.8-99.5 degrees Fahrenheit ) in core.
• Below 35 deg. ( 95 deg. F ) – Hypothermia
• 38-41 deg. ( 100.4-105.8 deg. F ) –
Hyperthermia
Breathing
• The breathing process is complexed from inhalation
to exhalation.
• In such, our body oxygenates, ventilates, looses\
gains heat to the environment
• Important parameters:
• Rhythm
• Depth
• Noises
• Excessive use of breathing muscles ( Tripod )
How to
• Look ( at chest rise ) Listen ( Exhale\Inhale ) and Feel
( with your hand ).
For 30 seconds. Multiply by two. Now you have
Respiration Rate ( number of breaths per minute ).
Do not inform the patient that you are checking
breathing!!!
Normal measurements:
Adult: 12-20
Child: 16-24
Infant: 20-30
Pulse
Medical definition: elevation of pressure of blood,
caused by the heart, upon the inner walls of
vessels.
Parameters:
Rhythm
Regularity
Power ( by an under trained caretaker only
with a blood pressure device )
Where should we feel?
Locations:
Carotid
Brachial
Radial
Femoral
How to?
Choose the location
Find pulse with 3 fingers
Count the beats for 15
seconds
Multiply by 4
Now you know the BPM
( number of beats per minute ).
Don’t press too hard.
Pulse
Proper values:
Adult: 60-100
Child: 80-120
Infant: 120-160
Skin
By observing the skin, we can
conclude a specific problem.
Important parameters:
Color
Temperature
Moisture
Skin
Signs of the skin:
Cyanotic ( blue/purple ) – hypoxemia
Pale ( White/Grey ) – Weak perfusion
Red – high body temperature/dilated vessels
Moist, Cold – Sympathetic reaction
Dry, Worm – Fever, Infection
Moist, Worm – Physical effort
Take in consideration that the last one
may be the early symptom for
Fever or
Spinal injury.
Capillary refill
Definition: The perfusion of blood to the fingers.
Important parameters:
Color
Speed
How to?
Apply firm pressure on the nail of the patient
The return of normal color shouldn’t take more than 2
seconds.
Take under consideration that capillary refill at other
locations may be different and usually slower.
Check for your self. Press the finger nail and time
and then press the skin of your palm.
Finger nail – 2 Sec. Golden standard
Blood Pressure
Definition: The pressure, applied by the blood
upon the vessels.
That pressure is build by the heart, the
contractility of the vessels and the amount of
fluid in side them.
The measurement of BP is in mmHg.
Blood Pressure
Systolic – The maximum pressure inside the
main arteries after the contraction of the heart.
Diastolic – The lowest pressure of the blood on

the vessels during the relaxation of the
ventricles ( just a fraction of the second before
the contraction ). Normally it doesn’t drop to
zero every beat.
Methods of measurement
Cuff and a stethoscope
( Systolic/Diastolic value )
Cuff and no stethoscope ( Systolic only )
Locations of measurement:
Between the elbow and the shoulder
Between the knee and the calves
Cuff and a stethoscope
• Find the brachial pulse – and adjust the
“plate”
• Place the cuff on and around the brachial
artery.
• Inflate to 180 mmHg
• Listen for pulse ( if you can still hear, inflate
more until you can not )
• Deflate slowly ( very ), notice the number on
which you can hear the pulse. ( Systolic BP -
higher )
• Keep deflating until you can not hear,
notice the number on which you’ve
stopped hearing. ( Diastolic BP - lower )
Cuff And No Stethoscope
• Find the radial pulse.
• Place the cuff on and around the
brachial artery.
• Inflate to 180 mmHg
• Feel for pulse ( if you can still hear,
inflate more until you can not )
• Deflate slowly ( very ), notice the
number on which you can feel the
pulse. ( Systolic BP - higher ).
• In this type of measurement we can
only get the Systolic measure
Once you have the Systolic/diastolic
Normal Difference is between 30 and 60 mmHg
Blood Pressure – how does it work
Step by step:
1. Before the inflation of the cuff – quiet
flow
2. Fully inflated cuff – no flow
3. Partial deflation – turbulent flow, that’s
when we hear the pulsation.
4. Fully deflated cuff – quiet flow
General assessment of BP
Take into consideration that

appearance of pulse in
peripheral places can indicate
general levels of sys measure.
Emphasis
• Pulse rate is the first line of compensation,
and varies greatly.
• When you check your patient, make sure he\
she does not feel that they are “being tested”.
• All signs are to be compared to the base line!
– Only when we do not have the base line
information available, do we go by the numbers
written in books.

Vital Signs

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Vital Signs

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VITAL SIGNS

• Sign – Objective, measurable

• Symptom – Subjective, evaluated by the

Diastolic – The lowest pressure of the blood on

Cuff and no stethoscope ( Systolic only )

Take into consideration that

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