Vital Signs & Stability: Quick Reference

Stability cues in vital signs

• Determine stability by symptoms plus vitals; some symptoms alone can be stable, others imply instability.
• Nausea by itself is generally stable; fever with illness may require treatment but not necessarily instability.
• Dizziness or confusion typically indicates instability; loss of consciousness is unstable.
• Chest symptoms (pain, pressure, palpitations) are unstable.
• Lungs: instability often shows as shortness of breath with hypoxia or dyspnea.

Lungs signs of instability

• Shortness of breath (dyspnea) → unstable.
• Low oxygen saturation (SpO₂) → unstable.$SpO_2 \downarrow$
• Difficult or labored breathing → unstable.

Symptoms by stability (examples from transcript)

• Nausea: stable
• Dizziness: unstable
• Confusion: unstable
• Loss of consciousness: unstable
• Chest pain: unstable
• Chest pressure: unstable
• Heart racing (palpitations): unstable
• Toe pain: stable
• Ringing in ears: stable (may depend on context)
• Stomach pain: stable
• Shortness of breath: unstable
• Difficulty breathing: unstable

Vital signs examples (instability cues)

• Case 1: $HR = 134$, $BP = 82/43$, $RR = 36$, Temp = normal → unstable
• Case 2: $HR = 94$, $BP = 138/82$, $RR = 44$, $SpO_2 \downarrow$ (desaturation) → unstable
• Case 3: $HR = 32$ → unstable

Quick takeaways

• Instability is indicated by combination of signs affecting heart, lungs, or brain: abnormal vitals + symptoms like chest pain, confusion, severe dyspnea, or loss of consciousness.
• Not all deviations imply instability (e.g., isolated nausea or stable toe pain).
• Very abnormal vitals (e.g., hypotension with tachycardia, severe tachypnea, or hypoxia) require urgent assessment.