Vital signs

Vital signs

Vital signs are measures of various physiological statistics often taken by health professionals in order to assess the most basic body functions. Vital signs are an essential part of a case presentation.

Primary four

There are four vital signs which are standard in most medical settings:

# Body temperature
# Pulse rate (or heart rate)
# Blood pressure
# Respiratory rate

The equipment needed is a thermometer, a sphygmomanometer, and a watch.

Though a pulse can often be taken by hand, a stethoscope may be required for a patient with a very weak pulse.

Additional signs

While various additional signs have been proposed, none have been officially universally adopted due to the expense in obtaining equipment required to diagnose and the difficulty in training entry-level professionals. However, body mass index (ratio of height to weight) has been introduced in recent years as an additional vital sign that is easy to measure and indicative of disease risk.

Fifth sign

The phrase "fifth vital sign" usually refers to pain, as perceived by the patient on a Pain scale of 0–10. [cite journal |author=Walid MS, Donahue SN, Darmohray DM, Hyer LA, Robinson JS |title=The Fifth Vital Sign—What Does It Mean? |journal=Pain Practice|volume= |issue= |pages= |year=2008 |pmid= |doi=10.1111/j.1533-2500.2008.00222.x] For example, the Veterans Administration made this their policy in 1999. However, some doctors have noted that pain is actually a subjective symptom, not an objective sign, and therefore object to this classification. [Harold S. Lee. November 2004. [http://www.asahq.org/Newsletters/2004/11_04/lte11_04.html Physical Diagnosis 101: A Lesson From the First Year of Medical School] , in Letters to the Editor. "American Society of Anesthesiologists", Volume 68, Number 11. ]

Other sources include pulse oximetry as their fifth sign. [cite journal |author=Mower W, Myers G, Nicklin E, Kearin K, Baraff L, Sachs C |title=Pulse oximetry as a fifth vital sign in emergency geriatric assessment |journal=Acad Emerg Med |volume=5 |issue=9 |pages=858–65 |year=1998 |pmid=9754497] [cite journal |author=Mower W, Sachs C, Nicklin E, Baraff L |title=Pulse oximetry as a fifth pediatric vital sign |journal=Pediatrics |volume=99 |issue=5 |pages=681–6 |year=1997 |pmid=9113944 |doi=10.1542/peds.99.5.681] [cite journal |author=Neff T |title=Routine oximetry. A fifth vital sign? |journal=Chest |volume=94 |issue=2 |pages=227 |year=1988 |pmid=3396392]

Some sources consider pupil size, equality, and reactivity to light to be a vital sign as well.Daniel Limmer and Michael F. O'Keefe. 2005. "Emergency Care" 10th ed. Edward T. Dickinson, Ed. Pearson, Prentice Hall. Upper Saddle River, New Jersey. Page 212 and 218.]

Sixth sign

There is no standard "sixth vital sign", and the use is much more informal and discipline-dependent than with the above, but some proposals (excluding the fifth sign candidates above) include:


*Urinary continence [cite journal |author=Joseph A |title=Continence: the sixth vital sign? |journal=Am J Nurs |volume=103 |issue=7 |pages=11 |year=2003 |pmid=12865635]
* End-tidal CO2 [cite journal |author=Vardi A, Levin I, Paret G, Barzilay Z |title=The sixth vital sign: end-tidal CO2 in pediatric trauma patients during transport |journal=Harefuah |volume=139 |issue=3-4 |pages=85–7, 168 |year=2000 |pmid=10979461]
*Emotional distress [cite journal |author=Bultz B, Carlson L |title=Emotional distress: the sixth vital sign--future directions in cancer care |journal=Psychooncology |volume=15 |issue=2 |pages=93–5 |year=2006 |pmid=16444764 |doi=10.1002/pon.1022 [http://www.jco.org/cgi/content/full/23/26/6440 link] ]
*Spirometry [http://www.ohsu.edu/medicine/residency/handouts/0405handouts/COPD091304.ppt ]
*Glucose [http://www.medicine.uiowa.edu/cme/about/documents/PrintHandout.ppt]
* Functional Status [cite journal |author=Bierman A |title=Functional status: the sixth vital sign |journal=J Gen Intern Med |volume=16 |issue=11 |pages=785–6 |year=2001 |pmid=11722694 |doi=10.1111/j.1525-1497.2001.10918.x [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1495293 link] ]
*Intracranial pressure
*Skin signs (color)

Variations by age

Children and infants have respiratory and heart rates that are faster than those of adults as shown in the following table:

See also

* Biotelemetry

References

External links

* [http://www.joannabriggs.edu.au/best_practice/bp8.php JBI]


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