EMT chapter 13

Vital Signs

Outward signs of what is going on inside the body, including respiration, pulse, skin, pupils, and blood pressure;

Baseline Vital Signs

The first set of vital sign measurements obtained to which later measurements are compared;

Stable Patient Vital Frequency

Vital signs should be repeated at least every 15 minutes;

Unstable Patient Vital Frequency

Vital signs should be repeated at least every 5 minutes;

Pulse

The rhythmic beats felt as the heart pumps blood through the arteries;

Pulse Rate

The number of pulse beats per minute;

Tachycardia

A rapid pulse; in an adult, any resting pulse rate above 100 beats per minute;

Bradycardia

A slow pulse; in an adult, any resting pulse rate below 60 beats per minute;

Normal Adult Pulse Range

Between 60 and 100 beats per minute at rest;

Adolescent Pulse Range (11–18 years)

60 to 100 beats per minute at rest;

School

Age Pulse Range (6–10 years)

Preschooler Pulse Range (3–5 years)

70 to 120 beats per minute;

Toddler Pulse Range (1–3 years)

80 to 140 beats per minute;

Infant Pulse Range (0–12 months)

90 to 160 beats per minute;

Newborn Pulse Range

100 to 170 beats per minute;

Pulse Quality

The rhythm (regular or irregular) and force (strong or weak/thready) of the pulse;

Thready Pulse

A pulse that feels weak and thin;

Radial Pulse

The pulse felt at the wrist on the thumb side of the forearm;

Brachial Pulse

The pulse felt in the upper arm; used for infants one year old or younger;

Carotid Pulse

The pulse felt along the large artery on either side of the neck;

Pediatric Pulse Warning

A low pulse in an infant or child is a greater concern than a high pulse and may indicate imminent cardiac arrest;

Respiration

The act of breathing in (inhalation) and breathing out (exhalation);

Respiratory Rate

The number of breaths taken in one minute;

Normal Adult Respiratory Range

Between 12 and 20 breaths per minute at rest;

Adolescent Respiratory Range (13–18 years)

12 to 20 breaths per minute;

School

Age Respiratory Range (6–12 years)

Preschooler Respiratory Range (3–5 years)

22 to 34 breaths per minute;

Toddler Respiratory Range (1–3 years)

24 to 40 breaths per minute;

Infant Respiratory Range

30 to 60 (0–6 months) or 24 to 30 (6–12 months) breaths per minute;

Newborn Respiratory Range

30 to 60 breaths per minute;

Labored Breathing Signs

Increase in work of breathing, use of accessory muscles, nasal flaring, and retractions;

Stridor

A harsh, high

Snoring

Indicates the airway is blocked; requires opening the patient's airway;

Wheezing

Indicates medical problems like asthma;

Gurgling

Indicates fluids in the airway; requires suctioning;

Pale Skin

Indicates constricted blood vessels, possibly from blood loss, shock, or hypotension;

Cyanotic Skin

A blue

Jaundiced Skin

A yellow tint to the skin resulting from liver abnormalities;

Mottled Skin

A blotchy appearance occasionally seen in patients with shock;

Pediatric Skin Assessment

The best places to check skin color in infants and children are the palms and soles;

Capillary Refill

Evaluation of circulation in children under 6; normal pink color should return within 2 seconds;

Pupil Reactivity

The black center of the eye reacting to light by changing size;

Dilated Pupils

Large pupils that may indicate fright, blood loss, or drug influence;

Constricted Pupils

Small, pinpoint pupils that may indicate narcotic use;

Unequal Pupils

May indicate stroke, head injury, or eye injury;

Systolic Blood Pressure

The pressure created when the heart contracts and forces blood into the arteries;

Diastolic Blood Pressure

The pressure remaining in the arteries when the left ventricle is relaxed and refilling;

Normal Adult Blood Pressure

A systolic pressure <= 120 mmHg and a diastolic pressure <= 80 mmHg;

Hypertension

High blood pressure defined as a systolic of 140+ or a diastolic of 90+;

Prehypertension

Readings between 121–139 systolic or 81–89 diastolic;

Pediatric Systolic BP Formula (Ages 1

10)

Sphygmomanometer

The medical device consisting of a cuff and gauge used to measure blood pressure;

Auscultation

The act of listening for characteristic sounds, such as BP sounds, using a stethoscope;

Palpation

Touching or feeling for a pulse or blood pressure;

Blood Pressure Cuff Placement

The center of the bladder must be placed directly over the brachial artery;

BP Cuff Contraindications

Avoid arms with shunts, fistulas, IVs, or same

Pediatric BP Requirement

Obtain a blood pressure on every patient older than 3 years;

Pulse Oximeter

An electronic device that determines oxygen saturation (SpO2) by sending light through tissue;

Oxygen Saturation (SpO2)

The ratio of oxygen present in the blood to the amount that could be carried;

Normal SpO2 Range

Between 96 percent and 100 percent in a healthy person;

Severe Hypoxia SpO2

An oxygen saturation reading of 85 percent or less;

Pulse Oximetry Caveats

Readings may be inaccurate in patients with shock, hypothermia, carbon monoxide, or nail polish;

Blood Glucose Meter

A device that analyzes a drop of blood to measure glucose concentration in mg/dL;

Normal Blood Glucose Level

Usually between 70 and 100 mg/dL;

Capnography

A method that measures the amount of carbon dioxide exhaled (ETCO2);

Normal ETCO2 Level

Between 35 and 45 mmHg;

ROSC Indicator

A sudden, substantial increase in end

Electronic Thermometer

A tool that provides a core temperature reading in seconds and is safer than glass in the field;