1

Vital signs

Pulse Respiration Temperature Blood pressure Pupils Colors Level of consciousness Reaction to pain Ability to move

A-2

Outlines

Reflects the rate of heart beats.Felt when an artery passes over a bone. near body surface.

Pulse check on both arms.Feel for: force and rhythm.

A-3

I - Pulse

A-4

1- Radial: artery of the wrist, below the thumb.2- Carotid: in groove created by windpipe and

large muscle in the neck. Commonly used in CPR.

3 - Temporal: in front of the ear.

4 – Femoral: near the groin.

5 – Brachial: located on the inside of upper arm.Used in infant during CPR.

6– Dorsalis pedis: over the dorsum of the foot.A-5

Commonest sites used

A-6

Temple College EMS Program A-7

Pulse Points

Pulse

Carotid

Brachial

Radial

Femoral

Popliteal

A-8

                                                

               Alternatively find the carotid pulse.

                                                    

        

      Alternatively find the carotid pulse.

                                                    

               Alternatively find the carotid pulse.

                                                    

        

Temple College EMS Program A-9

Pulse Points

Pulse

Dorsalis Pedis

Posterior Tibia

(Posterior and slightly inferior to medial Malleolus)

Normal heart rate: 60 – 100/ minute. Regular in rate and rhythm, strong to touch.

Tachycardia: Fast heart rate > 100/minute. Causes: exercise, infection, excitement,

shock, heart attack.

Bradycardia: Slow heart rate < 60/minute. Causes: sleep, rest, overdose of certain

drugs, hypoxia.

A-10

Heart rate

Normal respiratory rate is 12 – 16 /minute. Tidal volume ( air breathed in ) is 500 ml

Hyperventilation: increased respiratory rate. Occurs during exercise, infection, emotional

stress, shock.

Hypoventilation: decreased respiratory rate. Occurs during sleep, overdose of certain drugs. Apnoea: cessation of breathing.

A-11

II - Respiration

Average body temperatures is 37 C.

Hypothermia: low temperature Occurs in severe loss of body fluids through excessive vomiting, diarrhea, bleeding, shock.

Hyperthermia: high temperature Occurs as a result of infection, heat illness, injuries.

A-12

III - Temperature

Mouth: for one minuteAxilla: for four minutes.Rectally: for two minutes.Skin: using a special scale or feeling by the hand.

A-13

Sites of temperature measurement

Definition: pressure (force) exerted on the wall of the artery by the blood.

A-14

IV – Blood pressure

Systolic: the force to pump blood out of the heart.

Diastolic: resting period when pressure falls.

Normal blood pressure: 120/80 – 100/70.

A-15

Blood pressure

Hypertension: high blood pressure.Occurs in atherosclerosis, obesity, increasing age,exercise.

Hypotension: low blood pressure.Occurs in fluid loss in vomiting, diarrhea, shock, bleeding.

A-16

Place the patient in a position of comfort.

Support the bared arm, avoid constriction of arm.

Apply the cuff firmly.Cuff should be approximately 2.5 cm above antecubital fossa.

A-17

Measurement of blood pressure

sphygmomanometer,

a device used for measuring arterial pressure(MERCURY)

Stethoscope.

Cuff.

A-18

A-19

A-20

A-21

A-22

A-23

A-24

five phases of Korotkoff sounds

A-25

Examine both eyes. Check pupils for size, equality and

responsiveness Normal: equal, and reactive to light. Constricted unresponsive:CNS disease, narcotics e.g. heroin, morphine. Dilated unresponsive: Cardiac arrest.

Unequal: in stroke, head injury.

V – Pupils

A-27

A-28

Normal healthy flushing after pressing for few seconds on skin, ear lobes, tip of fingers.

Pale skin: in severe bleeding, shock, hypotension.

Cyanosis (blue ): due to hypoxia, airway obstruction, heart failure.

Pink coloration: carbon monoxide poisoning.

Yellow coloration (jaundice): in hepatitis, hemolytic anemia, obstructive jaundice.

A-29

VI – Colors of skin and mucous membranes

Used to assess responsiveness during:

Cardiac arrest, Head injuries, Comatose patients

A-30

VII – Level of consciousness

Response can be tested by:1-Pinching the earlobe2-Pressing over the eye brow3-Rubbing the sternum4-Using a pin or sharp object.

A-31

VIII – Reaction to pain

Assessed if the patient is conscious, with no evidence of injury to extremities, and suspected spinal injury. Both sides are tested.

Upper extremitiesAsk patient to grasp your hand.

Lower extremitiesAsk patient to press sole of his foot against your hand.

A-32

IX – Ability to move

33

Thank you