Ch(11): Vital Signs

Front 1

What is the normal pulse rate for an Elder?

Back 1

90/min

Front 2

What is the normal pulse rate for an adult?

Back 2

Normal: 60-100/min

Tachycardia: 100+ min

Bradycardia: below 60

Front 3

What is the normal pulse rate for an adolescent?

Back 3

Normal: 60-105

Rapid: Above 105+

Slow: Below 50

Front 4

What is the normal pulse rate for a child (5-12)?

Back 4

Normal: 60-120

Rapid: Above 120+

Slow: Below 60

Front 5

What is the normal pulse rate for a child (1-5)

Back 5

Normal: 80-150

Rapid: 150+

Slow: Below 80

Front 6

What is the normal pulse rate for an infant?

Back 6

Normal: 120-150

Rapid: 150+

Slow: Below 120

Front 7

What is the Normal pulse Rate of a newborn?

Back 7

Normal: 100-180

Front 8

This Vital sign is very useful in children and infants. It is where we press firmly on the skin or nail bed. It ultimately test perfusion and circulation. Helps to determine shock.

Back 8

Capillary Refill

In Children: Should take 2 seconds

Females: 3 seconds

Elderly: 4 seconds

Really only useful at room temp

Front 9

The Pupils are useful in assessment and part of the major vital signs. What main 3 categories do we look for?

Back 9

1) size

2) Equality

3) Reactivity

Front 10

What can Dialted Pupils indicate?

Back 10

Cardiac arrest, OD, drugs

Front 11

Constricted pupils mean?

Back 11

CNS disorder or narcotic use

Front 12

Unequal Pupils mean?

Back 12

Stroke, Head injury, eye trauma

Front 13

Non-reactive pupils can indicate?

Back 13

Cardiac arrest, brain injury, drug intoxication, or overdose. They can be fixed and dilated.

Front 14

How do we check the pupils?

Back 14

Take a pen light and briefly shine a penlight into the patients eyes. It is important to assess how briskly the pupils respond to light. Sluggish pupils may indicate a poor oxygen state.

Front 15

Another important baseline/vital sign is Blood Pressure. What is systolic pressure? What is diastolic?

Back 15

Systolic= pressure exerted on the arteries when the heart contract

Diastolic= pressure exerted on the arteries when the ventricle is at rest

* When reading a pressure between 110 and 112 it is not 111, we round up. Good to know.

Front 16

What is a normal systolic and diastolic pressure for adult male?

Back 16

Normal Systolic: 100+

Normal Diastolic: 60-85

* If less than 40 years of age we add the patients age to 100, this would be normal* EX: 32 years old normal systolic should be 132.

Systolic: Greater than 140= hypertension

Diastolic Greater than 90= hypertension

Front 17

What is a normal systolic and diastolic pressure for an adult female?

Back 17

Normal Systolic: 90+

Normal Diastolic: 60-85

*Same principle but we take 90 , plus patients age for a normal systolic pressure*

Front 18

We don't worry to much about children when it comes to BP because it can vary greatly.

Back 18

Just know

Front 19

What are the two main methods that we measure blood pressure?

Back 19

Ausultation= Listening

Palpation= feeling

Front 20

In a patient with suspected volume loss, we may need to obtain a set of __________ vital signs. This is done by placing a patient in a supine position and measuring his blood pressure and heart rate. Then stand them up for 2 minutes and reassess the signs. This is AKA the _____ test.

Back 20

Orthostatic

Tilt

Front 21

How often should we reassess Vital signs?

Back 21

If stable: Every 15 minutes

If unstable: Every 5 minutes

Front 22

This is a method of detecting hypoxia in patients by measuring oxygen saturation levels in the blood. The device we use to measure this is?

Back 22

Pulse Oximeter

It is not useful for diagnosis, but can help determine if the method of treatment is effective.

Front 23

In addition to just the rate of the pulse we must also consider the quality. What are some of the related problems?

Rapid, regular, and full:

Rapid, regular and thready:

Slow:

No pulse:

Back 23

1) Exertion, fright, fever, high BP, or early stage blood loss

2) Reliable sign of shock, often evident in early stage of blood loss

3) Head Injury, Barbiturate or narcotic use, some poisons, possible cardiac issue, or hypothyroidism

4) Cardiac Arrest

Front 24

This is known as ______ is a decrease in the strength of the pulse during inspiratory phase of the patient. This could be an indication of a severe cardiac or respiratory injury or illness, or significant blood loss.

Back 24

Pulses Paradoxus

Front 25

The appearance and condition of the skin is another important indicator of the body's perfusion status. In all patients when looking at skin what specific parts should we look at?

Back 25

Check the color of the nail beds

oral mucosa

conjunctiva (eyelid)

Front 26

Note what these colors of the skin mean:

1) Pallor(white):

2) Cyanosis(blue-gray):

3) Flushing(red):

4) Jaundice(yellow):

Back 26

1) Vasoconstriction, blood loss shock, Heart Attack, fright, anemia, fainting, distress.

2) Inadequate Oxygenation or perfusion, inadequate respiration, heart attack

3) Heat exposure, Carbon monoxide poisoning

4) Liver Disease

Front 27

Note what these temperatures in the skin mean:

1) Hot:

2) Cool:

3) Cold:

Back 27

1) Fever, heat exposure

2) Poor perfusion (shock), cold exposure

3) Extreme cold exposure

Front 28

Note what these skin conditions can indicate:

1) Wet or moist:

2) Abnormally dry

*cool and moist=clammy)

*diaphoresis=profuse sweating

Back 28

1) Shock, heat emergency, diabetic emergency

2) Spinal injury, dehydration, heat stroke, poisoning, hypothyroidism

Front 29

When taking a patients history, we typically start with determining __________. It is the reason why the EMS crew is called to the scene.

Back 29

The chief complaint

Front 30

When taking history, etc. Make sure to include the time date and other identifying data. Use open-ended (how are you today?) and close-ended questions ( yes or no). There is a standardized approach to history taking. What is it?

Back 30

The SAMPLE History

Front 31

Break down the Acronym of SAMPLE

Back 31

S= Signs and symptoms

A= Allergies

M=Medications

P= Pertinent past history

L= Last oral intake

E= Events leading to the injury or illness

Front 32

What is the difference between a sign and a symptom?

Back 32

A sign is any objective physical evidence of medical or trauma conditions that you can hear, feel, or smell.

Symptoms are conditions that cannot be observed and must be described by the patient, such as pain in the abdomen or numbness in the legs.

Front 33

Assessing Patient Complaints:

OPQRST is mnemonic for remembering the questions to ask when assessing the patient's chief complaint or major symptoms, such as pain, that the patient can tell you about. Break it down.

Back 33

O= Onset

P= Provacation/palliation/position

Q= Quality

R= Radiation

S= Severity

T= Time

Front 34

What do we mean by the P, Q and R?

Back 34

Provocation=What makes the symptom worse? What makes it better? In what position is the patient found?

Quality= How would you describe this pain

Radiation= Where do you feel the pain? Where does it go?