A R A V I N D E Y E C A R E S Y S T E M Vital Signs Dr. Banushree Physician.

A R A V I N D E Y E C A R E S Y S T E MA R A V I N D E Y E C A R E S Y S T E M

Vital Signs

Dr. Banushree

Physician


Vital Signs

• Pulse

• BP

• Temperature

• Respiration


Pulse

• It is the rhythmic expansion of the

artery which occurs with each

ventricular contraction


Following Statements are True / False

Pulse rate is same for all ages False

Only radial artery is used to feel pulse False

Carotid pulse should never be felt

bilaterallyTrue

Pulse gives a good idea about patients health.

True

Resting Heart Rate Chart

Resting heart rate

Age or fitness level Beats per minute (bpm)

Babies to age 1 100–160

Children ages 1 to 10 60–140

Children age 10+ and adults 60–100

Well-conditioned athletes 40–60


Sites for Checking Pulse

• Temporal artery

• Facial

• Carotid

• Radial

• Femoral

• Dorsalis Pedis


Method of checking radial pulse

• 3 fingers are used to

feel the radial pulse on

thumb side of wrist

• To palpate for 1 minute


Sites for checking pulse

• Temporal Artery

• Above outer side of outer canthus of eyes

• Carotids

– Thumb to be used on inner side of

sternomastoid muscle on either side of neck

Brachial


Sites for checking pulse

• Femoral Artery

– Feel in the Groin between anterior superior

spine of illium and symphysis pubis

• Dorsalis pedis

– On the in step of the foot


Characters of pulse

• Rate

• Rhythm

• Volume

• Tension


Rate

• Pulse rate more than 100 /mt is called tachycardia

• Common causes of techycardia

– Excitement

– Fever

– Anemia

– Thyrotoxicosis

– Tachyarthythmias


Bradycardia

• Pulse rate less than 60 / mt is called bradycardia.

• Causes of bradycardia

– Sleep

– Old age

– Atheletes

– Hypothyrodism

– Heart block


Rhythm

• Irregular pulse is seen in

– Atrial Fibrillation

– Ventricular Ectopics


Staging of Hypertension

• Normal – 120/80mmHg

Systolic Diastolic

High Normal 130-139 85-89

Grade I H7 140- 149 90-99

Grade II H7 >160 >100


Measurement of BP

BP Measurement

Measurement of BP• Palpatory method

• Auscultatory method

• Step 1 : Patient to rest for 5 minutes

• Step 2 : Cuff is level with heart

• Step 3 : Inflate cuff, palpate radial artery until 20-30mmHg

above disapperance of pulse

• Step 4 : Place stethscope over brachial artery in antecubital

fossa and deflate cuff at rate of 2 to 5 mmHg/sec

• Step 5 : listen for first sound (Korokoff phase1) – Systolic BP

Disapperance of all sounds (Korokoff phase 5)

Diastolic blood pressure


Why do need to do both palpation & Auscultation

• Severe HT has “Auscultatory Gap” which

might be missed

• BP has to be measured by both methods


Common inaccuracies in BP recording

• Patient not relaxed

• Cuff not at heart level

• Rapid deflection

• Arm unsupported

• Inadequate cuff size


Cuff size

• Standard adult - 12.5 x 22.5cm

• Obese adult - 17.5 x 37.5cm

• Child - 5 x 18cm


Diagnosis of Hypertension

• Average of 3 BP measurements

• Investigations

– Albumin deposits

– Blood urea

– Sr. Creatinine

– Sr. Electrolytes


Complications of Hypertension


Temperature

• Taken by thermometer

• Normal body temperature is 37 C (Centigrade)

(or) 98.6 F (Fahrenheit)

• Measured by 3 routes

– Oral

– Axilla

– Rectal


Thermometer


Thermometer

• It is a delicate hollow tube with

mercury

• Mercury expands when temperature

goes up and shrinks when

temperature goes down.


Precautions before Taking Temperature

• Always take temperature in sitting

position

• Shake till mercury column is < 96F

• Avoid taking temperature if patient

has consumed hot or cold liquids


Oral Temperature

• Wash Hands

• Take thermometer out of container and

wash with cold water

• Hold thermometer with thumb & first two

fingers

• Keep under tongue

Axillary temperature

Indications• Unconscious patient• Uncooperative patient• Children• Method

– Place tip of thermometer in centre of axilla

– To add one degree


Rectal Temperature

• Put lubricating jelly on tip of thermometer.

• Insert thermometer gently one inch into

rectum.

• Minus one degree done

• Indications

– Children

– Unconscious patient

• Major surgery in face & neck


• Temperature regulating centre – hypothalamus in brain

• Hypothermia

– Temperature < 95 F

• Fever (pyrexia)

– Temperature > 98.6 F• Hyperpyrexia

– Temperature > 106 F


Respiration

• Normal rate 16 – 20 times per/minute

• Method

• Hold wrist of patients over is chest

• Count number of times patients chest

rises for 60sec

A R A V I N D E Y E C A R E S Y S T E M Vital Signs Dr. Banushree Physician.

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