Measuring Vital Signs
Source: Meghan Fashjian, ACNP-BC, Beth Israel Deaconess Medical Center, Boston MA
The vital signs are objective measurements of a patient's clinical status. There are five commonly accepted vital signs: blood pressure, heart rate, temperature, respiratory rate, and oxygen saturation. In many practices, pain is considered the sixth vital sign and should regularly be documented in the same location as the other vital signs. However, the pain scale is a subjective measurement and, therefore, has a different value according to each individual patient.
The vital signs assessment includes estimation of heart rate, blood pressure (demonstrated in a separate video), respiratory rate, temperature, oxygen saturation, and the presence and severity of pain. The accepted ranges for vital signs are: heart rate (HR), 50-80 beats per minute (bpm); respiratory rate (RR), 14-20 bpm; oxygen saturation (SaO2), > 92%; and average oral temperature, ~98.6 °F (37 °C) (average rectal and tympanic temperatures are ~1° higher, and axillary temperature is ~1° lower compared to the average oral temperature).
Vital signs serve as the first clue that something may be amiss with a patient, especially if the patient is unable to communicate. Although there are quoted normal ranges, each patient should be considered as an individual and not treated without taking into account the entire clinical picture.
Make sure the patient has been seated and resting for at least 5 minutes prior to obtaining vital signs (VS) to accurately determine the baseline.
1. Heart rate
The radial artery is the most common site used to assess the pulse.
- Explain to the patient that you are going to start by checking their pulse.
- Place your index and middle fingers on the radial pulse (never use the thumb, as you can sometimes feel your own pulse). To prevent occlusion,
The vital signs - blood pressure, heart rate, respiratory rate, temperature, oxygen saturation, and "the 6th vital sign", pain - are often the first pieces of objective evidence gathered before formal evaluation of the patient. These simple non-invasive measurements provide essential (i.e., vital) insight into a patient's clinical status, as they can indicate early objective changes prior to the onset of symptoms.
A medical practitioner should be familiar with accepted variations in
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