1012 vital signs.ppt
TRANSCRIPT
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UNCLASSIFIED
UNCLASSIFIED
THE VITAL SIGNSTHE VITAL SIGNS
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UNCLASSIFIED
UNCLASSIFIED
HE LOOKS BAD
BY MEASURING THE VITAL SIGNS ONLY YOUCAN HAVE A RELIABLE ASSESSMENTOF
CASUALTYS CURRENT CONDITIONS
YOUR FINDINGS WILL LEAD YOU TO
DECISIONS FOR TREATMENT
FROM THE VITAL SIGNS TREND YOU CAN CHECK
THE EFFECTIVENESS OF INTERVENTIONSAND
FORESEE THE EVOLUTION
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UNCLASSIFIED
UNCLASSIFIED
REFERENCES
PRE HOSPITAL TRAUMA LIFE SUPPORT (PHTLS)MILITARY7thEDITION 2011 ISBN 978-0-323-06503-0
CHAPTER 6 PP! ""#$""%
CHAPTER PP! "'$"'6
CHAPTER * PP!+'$*
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UNCLASSIFIED
UNCLASSIFIED
THE VITAL SIGNS
THEY ARE CALLED VITAL SIGNS BECAUSE THEY GIVEAN INDICATION OF THE PATIENTS MAIN CONDITIONS
TEMPERATURE
PULSE
BLOOD PRESSURE
RESPIRATION
ANY MARKED DEVIATION FROM THE NORM IS A
DISTRESS SIGNAL FROM THE BODY
CHANGESOVER TIME ARE AS IMPORTANT AS THE
MEASUREMENT ITSELF
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UNCLASSIFIED
UNCLASSIFIED
BODY CORE TEMPERATURE
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IS THE RESULT OF A BALANCE BETWEEN HEAT PRODUCED
HEAT LOST
HYPOTHALAMUS IS RESPONSIBLE FOR THE
REGUALTION BY SPEEDING UP OR SLOWING DOWNTHE CELLS METABOLISM
INCREASE IN METABOLISM INCREASE IN HEAT
HEAT IS DISTRIBUTED BY BLOOD AND IT IS LOST
THROUGH SKIN LUNGS BREATHING E.CRETIONS IF BALANCE IS DISTURBED DEVIATIONS IN BODY CORE
TEMPERATURE OCCURS
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UNCLASSIFIED
UNCLASSIFIED
NORMAL BODY CORE TEMPERATURE
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THE NORMAL AVERAGE BODY CORE TEMPERATURE
FOR MOST PEOPLE IS #+!* C '!F
THE TEMPERATURE WILL VARY DEPENDING UPONTHE SITEUSED TO TAKE THE TEMPERATURE,
RECTAL IS THE MOST ACCURATE
A.ILLARY / ORAL CIRCA " DEGREE LOWER
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UNCLASSIFIED
UNCLASSIFIED
MEASURING TEMPERATURE
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THE TEMPERATURE CAN BE MEASURED AT,
THE MOUTH (ORAL)
THE RECTUM (RECTAL)
THE ARMPITS (A.ILLARY)
THE METHOD USED WILL DEPEND ON
THE PATIENTS AGE
THE PATIENTS PHYSICAL CONDITION
E2UIPMENT AVAILABLE
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UNCLASSIFIED
UNCLASSIFIED
ORAL TEMPERATURE
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IS THE MOST CONVENIENT METHOD
USED FOR RESPONSIVE ADULT PATIENTS
IF THE PATIENT HAS HAD FOOD OR DRINK
OR HAS BEEN SMOKING WAIT "% MINUTES WHEN HANDLING THERMOMETERS HOLD
ONLY BY THE STEM END
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UNCLASSIFIED
ORAL TEMPERATURE 3 PROCEDURE
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WASH HANDS
CHECK THERMOMETER AND SHAKE DOWN TO 1#%C
PLACE BULB END UNDER PATIENTS TONGUE
INSTRUCT PATIENT TO CLOSE LIPS AND NOT TO BITE
LEAVE THERMOMETER FOR AT LEAST # MINUTES
REMOVE READ AND RECORD TEMPERATURE
WIPE CLEAN WITH MEDISWAB
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UNCLASSIFIED
RECTAL TEMPERATURE
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IS THE MOST ACCURATE METHOD (4) USED FOR INFANTS AND YOUNG CHILDREN
UNCONSCIOUS / UNRESPONSIVE ADULTS
SUSPECTED HYPOTHERMIA
DO NOT USE ON PATIENTS WHO HAVE A RECTAL
DISORDER
(4) LATEST RESEARCHES INDICATE THAT THE EAR$DRUM
TEMPERATURE IS THE MOST ACCURATE BUT ARE
EAR$THERMOMETERS AVAILABLE / USEFUL IN THE FIELD5
UNCLASSIFIED
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RECTAL TEMPERATURE $ PROCEDURE
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TURN PATIENT ON HIS SIDE TOP KNEE BENT
E.POSE BUTTOCK BUT KEEP PATIENTS PRIVACY
SHAKE DOWN
LUBRICATE
E.POSE ANUS
INSERT BULB SLOWLY ABOUT #7 ASKING THE
PATIENT TO TAKE A DEEP BREATH
HOLD IN PLACE FOR MIN (YOU DO IT)
REMOVE READ AND RECORD TEMPERATURE
CLEAN WITH MEDISWAB / USE DISPOSABLE
THERMO COVERS
UNCLASSIFIED
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UNCLASSIFIED 15
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UNCLASSIFIED
A.ILLARY TEMPERATURE
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USED WHEN TEMPERATURE CANNOT BE TAKEN BY OTHERMETHODS
PROCEDURE,
DRY ARMPIT
PLACE BULB IN CENTRE OF ARMPIT POINTED TOWARDPATIENTS HEAD
FOLD ARM ACROSS CHEST AND LEAVE FOR AT LEAST "*MINUTES
REMOVE READ AND RECORD TEMPERATURE
CLEAN WITH MEDISWAB
UNCLASSIFIED
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UNCLASSIFIED
UNCLASSIFIED
RECORDING TEMPERATURE
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ALWAYS USE DECIMALS8!9! #+!"
WRITE THE UNITC8:;? F@-?8-8
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UNCLASSIFIED
UNCLASSIFIED
THERMOMETERS
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MOST COMMON TYPES ARE, ELECTRONIC DIGITAL THERMOMETER
MERCURY FILLED THERMOMETER (BLUE TIP)
OTHER TYPES ARE,
SINGLE$USE CLINICAL THERMOMETER
8!9! #M TEMPADOT
EAR SCANNING
UNCLASSIFIED
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UNCLASSIFIED
LOW READING THERMOMETERS ARE AVAILABLE MERCURY FILLED
USED FOR TAKING AN ACCURATE TEMPERATUREFROM POSSIBLE HYPOTHERMICCASUALTY
SCALE RANGES FROM %C TO*C
CONSIDER ADDING ONE TO THE MEDIC BAG WHENOPERATING IN COLD WET CLIMATES
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LOW READING THERMOMETERS
UNCLASSIFIED
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UNCLASSIFIED
THE PULSE
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IT IS DEFINED AS THE E.PANSION AND CONTRACTION
OF AN ARTERY CAUSED BY THE HEART BEATING
NORMALLY RHYTHMIC
WHEN THE HEART CONTRACTS BLOOD IS FORCED
INTO THE ARTERIES THE PULSE WAVE CAUSES AN E.PANSION ALONG
THE ARTERIES
A PULSE IS MEASURED AS AN AID TO DETERMINING
THE PATIENTS CONDITION BY COMPARING IT WITHNORMAL HEART RATE
UNCLASSIFIED
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UNCLASSIFIED
PULSE SITES
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THE PULSE CAN BE PALPATED AT POINTS WHERE AN
ARTERY LIES CLOSE TO THE SKIN OR WHERE IT CROSSESA BONE,
WRIST (RADIAL)
NECK (CAROTID)
GROIN (FEMORAL)
UPPER ARM (BRACHIAL)
INNER ANKLE (POSTERIOR TIBIAL)
TOP OF THE FOOT (DORSALIS PEDIS)
UNCLASSIFIED
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UNCLASSIFIED
UNCLASSIFIED
NORMAL PULSE RATES
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THE NORMAL PULSE IS REGULAR IN, RATE(7)
RHYTHM(PAUSES BETWEEN BEATS)
STRENGTH(E.PANSIONVOLUME OF BLOOD) A
STRONG PULSE IS EASILY DETECTED DUE TOTHE LARGE VOLUME OF BLOOD BEING PUMPED
THE AVERAGE RATE IN ADULTS IS BETWEEN 6* $ *PULSE BEATS PER MINUTE (7)
THE ABNORMAL PULSE RATES ARE CALLED
BRADYCARDIA (SLOWER THAN NORMAL)
TACHYCARDIA (FASTER THAN NORMAL)
UNCLASSIFIED
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UNCLASSIFIED
UNCLASSIFIED
BRADYCARDIA
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IT IS A PULSE RATE BELOW 6* 7
PATIENTS WITH HEART DISEASE MAY HAVE A SLOW
HEART RATE DUE TO DRUGS
ATHLETESMAY HAVE A NORMAL PULSE BELOW 6*
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UNCLASSIFIED
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UNCLASSIFIED
TACHYCARDIA
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IT IS A PULSE RATE OVER "** 7PHYSIOLOGICAL CAUSES
EMOTION
E.ERCISE
PAIN
PATHOLOGICAL CAUSES
FEVER
SHOCK
UNCLASSIFIED
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UNCLASSIFIED
PULSE & BLOOD PRESSURE
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THE PULSE CAN BE USED AS A SIMPLE INDICATOR TO
ESTIMATE THE BLOOD PRESSURE ESPECIALLY IN THE
TRAUMA CASUALTY ASSESSMENT,
RADIAL PULSE PRESENT BP AT LEAST * 77H9
FEMORAL PULSE PRESENT BP +* 0 1 * 77H9
CAROTID PULSE PRESENT BP 6* 0 1 +* 77H9
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UNCLASSIFIED
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UNCLASSIFIED
THE CAROTID PULSE
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IF NO RADIAL NEITHER FEMORAL BUT YOU FEEL THE
CAROTID PULSE THEN THE BLOOD PRESSURE IS
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UNCLASSIFIED
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UNCLASSIFIED
NORMAL AVERAGE OF
RESPIRATORY RATES
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UNCLASSIFIED
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UNCLASSIFIED
SIMPLIFIED BP MEASUREMENT
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IN THE BATTELFIELD (TRAUMA/MASS CASUALTY) BP CAN BE ESTIMATEDACCORDING TO THE
PRESENCE OF DIFFERENT PERIPHERAL PULSES (NO E2UIPMENTIS NEEDED FOR THIS IMMEDIATEAPPROACH)
RADIAL PULSE PRESENT BP AT LEAST * 77H9
FEMORAL PULSE PRESENT BP +* 0 1 * 77H9
CAROTID PULSE PRESENT BP 6* 0 1 +* 77H9
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UNCLASSIFIED
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UNCLASSIFIED
SKIN COLORATION "/
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TO EVALUATE THE SKIN COLOR IS IMPORTANT
REDNESS OR ERYTHEMA 8!9! FEVER INFLAMMATION ALLERGIES HYPERTENSION HEAT STROKE BURNS
PALLOR OF BLANCHING SKIN 8!9! EMOTIONAL STRESS LIKE FEAR & ANGER ANEMIA LOW BLOOD PRESSURE ORHYPOVOLEMIC SHOCK
JAUNDICE A YELLOWISH SKIN8!9! LIVER DISORDER IN WHICH THE E.TRA AMOUNT OF BILE PIGMENTS IN THE BLOOD ISABSORBED BY THE SKIN (ICTERUS OR HEPATITIS)
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