VITAL SIGNS
PRESENTED BY:
Oyebanji Oyindamola and Otubela Abdumalik
DEFINITION
Vital sign measurements are a crucial aspect of
physiotherapy assessment, screening for potential
red flags and to guide treatment. These
measurements are termed "vital" as their
measurement and assessment is the critical first
step for any clinical evaluation.
Vital signs are indicators of a persons health condition and
normal measurements provide assurance of proper
circulatory, respiratory, neural, and endocrinal functions.
Furthermore, they are commonly used to universally
communicate a patient's condition and severity of the
disease.
Vital signs play an important role in emergency
departments (ED) and on the wards, to determine patients
at risk of deterioration.
Normal Vital Signs
Normal vital signs vary based on your age, BMI, sex and
overall health.
> Temperature: 97.8 F to 99.1 F (36.5 C to 37.3 C).
> Blood pressure: 90/60 mm Hg to 120/80 mm Hg.
> Pulse: 60 to 100 beats per minute.
> Respiratory rate: 12 to 18 breaths per minute.
What are pediatric vital signs?
• Pediatric vital signs, or vital signs for children, measure a
child’s basic body functions. The measurements are
different for children than they are for adults. For
example, a baby’s pulse may range from 110 to 160
beats per minute (bpm) and an adult’s heart rate ranges
from 60 to 100 bpm.
What are orthostatic vital signs?
• Orthostatic vital signs check blood pressure and pulse
when lying down, and then when standing up. Vital signs
may change when position changes if there has been
experience or risk of:
• Hypovolemia.
• Lightheadedness.
• Falling.
• Weakness.
• Loss of consciousness.
• Concussion.
Vital signs consist of:
1. Temperature
2. Pulse rate
3. Blood pressure
4. Respiratory rate.
5. Blood oxygen saturation via pulse oximetry
BODY TEMPERATURE
• The human body temperature typically ranges from 36.5 to 37.5 degrees. A
temperature higher than 100.4 F (38 C) is classified as a fever. A drop in
body temperature below 95 F (35 C) is hypothermia.
• Body temperature can be measured in any of the following ways:
1. Orally: Either a glass thermometer or a digital thermometer that uses an
electronic probe can measure body temperature from the mouth.
2. Rectally: Temperatures taken rectally using a glass or digital thermometer
tend to be a bit higher than when taken by mouth.
3. Axillary: Temperatures taken under the arm using a glass or digital
thermometer tend to be a bit lower than temperatures taken by mouth.
4. By ear: A special thermometer can quickly measure the temperature of the
eardrum, which reflects the body’s temperature.
5. By skin: A special thermometer can quickly measure the temperature of the
skin on the forehead.
FEVER
• A fever is when body temperature rises to a level that’s
higher than normal. In general, you have a fever if your
temperature is:
• In adults: higher than 99°F to 99.5°F (37.2°C to 37.5°C)
• In children: higher than 99.5°F (37.5°C)
• In infants: higher than 100.4°F (38°C)
• Fevers are often short-term increases in body
temperature that help the body fight infection or
illness. However, a severe or sustained fever
can indicate a more serious condition that
warrants medical attention.
• Typically, the following temperatures suggest
that someone has a fever:
• at least 100.4°F (38°C) is a fever
• above 103.1°F (39.5°C) is a high fever
• above 105.8°F (41°C) is a very high fever
Factors affecting body temperature?
• Being in a hot or cold environment.
• Exercise.
• Eating hot or cold foods and beverages.
• Strong emotions.
• Stress.
• Infection.
• Hypothyroidism.
• Dehydration.
• Sunburn.
• Rheumatoid arthritis.
• Hormonal changes.
BLOOD PRESSURE
• Blood pressure is the force of circulating
blood on the walls of the arteries, mainly in
large arteries of the systemic circulation. It
is one of the most commonly measured
clinical parameters and blood pressure
values are major determinants of
therapeutic decisions.
According to the 2017 ACC/AHA Guideline for the Prevention, Detection,
Evaluation, and Management of High BP in Adults .
BP Category SBP, mm Hg DBP, mm Hg
Normal <120 <80
Elevated 120–129 <80
Hyper tension
Stage 1 130–139 80–89
Stage 2 ≥140 ≥90
• Blood pressure that remains high for an
extended time, for example, longer than a few
years, can cause health issues, including:
• Atherosclerosis (hardening of your arteries).
• Heart failure.
• Stroke.
Factors that can affect blood pressure
reading include:
• Caffeine or beverages containing alcohol.
• Certain medications.
• Weight loss or weight gain.
• Cold temperatures.
• Exercise.
• A full bladder.
• A full stomach.
• The amount of salt in your diet.
• Smoking.
• Stress.
• Blood pressure is
measured by BP cuff,
sphygmomanometer and
stethoscope. The BF cuff
has a rubber bag that can
be inflated with air called
the bladder which has
two tubes; one to the
rubber bulb that traps and
releases air into the cuff
and the other is
connected to the
sphygmomanometer to
monitor the pressure in
the bladder.
• BP site: Upper arm using the brachial
artery, Thigh using the popliteal artery and
the ankle using the dorsalis pedis artery.
• TYPES OF SPHYGMOMANOMETER
• Aneroid
• Digital
• Mercury
PULSE RATE
It is the number of times the heart beats per minute. The
pulse is lower when at rest and higher during exercise. This
happens because the body needs more oxygen-rich blood
during exercise.
• The normal range used in an adult is between 60 to 100
beats /minute with rates above 100 beats/minute and
rates and below 60 beats per minute, referred to as
tachycardia and bradycardia, respectively. Changes in
the rate of the pulse, along with changes in respiration is
called sinus arrhythmia. In sinus arrhythmia, the pulse
rate becomes faster during inspiration and slows down
during expiration.
Factors that can affect pulse include:
• Exercise.
• Stress.
• Strong emotions.
• Caffeine.
• An infection.
• Dehydration.
• Stress.
• Anxiety.
• Thyroid conditions.
• Anemia.
• Shock.
• Arrhythmia.
• Some medications, especially beta-blockers and digoxin, can slow
down the pulse.
• Pulse Site: Temporal, Carotid, Apical,
Brachial, Radial, Femoral, Popliteal,
Posterior tibia, Dorsalis pedis.
• Pulse rate is assessed by palpation or
auscultation. The 3 middle fingers are
used on the pulse site (except Apical site).
Moderate pressure is used because deep
pressure might not allow the pulse to be
felt. The thumb is not used for palpation
because of the presence of an artery
there.
• Pulse Measurement
• Doppler ultrasound is a machine that uses
high frequency sound waves to the
measure the amount of blood flow through
the arteries and veins, usually those that
supplies the UL&LL. It is useful in the
diagnosis of blood clot and poor
circulation.
Respiratory rate
It is the is the number of breaths taken per minute. The normal respiratory rate
for an adult at rest is 12 to 18 breaths per minute. A respiration rate under 12 or
over 25 breaths per minute while resting may be a sign of an underlying health
condition.
• Rates higher or lower than expected are termed as tachypnea and
bradypnea, respectively. Tachypnea described as a respiratory rate more
than 20 beats per minute could occur in physiological conditions like
exercise, emotional changes, pregnancy, and pathological conditions like
pain, pneumonia, pulmonary embolism, asthma, etc. Bradypnea which is
ventilation less than 12 breaths/minute can occur due to worsening of any
underlying respiratory condition leading to respiratory failure or due to usage
of central nervous system depressants like alcohol, narcotics,
benzodiazepines, or metabolic derangements. Apnea is the complete
cessation of airflow to the lungs for a total of 15 seconds which may appear
in cardiopulmonary arrests, airway obstructions, the overdose of narcotics
and benzodiazepines.
What conditions affect respiratory rate?
> Asthma.
> Anxiety.
> Pneumonia.
> Heart disease.
> Lung disease.
OXYGEN SATURATION
• Oxygen saturation compares how much oxygen has
bound to hemoglobin in the blood with how much has not.
The hemoglobin in red blood cells transports oxygen
around the body, so this can show how much oxygen
tissues can use to function well.
• Oxygen saturation can help identify lung disease and life
threatening events involving low oxygen
• It can be measures as part of screening and assessment
for respiratory diseases, such as COVID-19 or chronic
obstructive pulmonary disease (COPD).
• A normal oxygen saturation is between 95% and 100%.
It can be measured using pulse oximetry
• Oxygen saturation can drop for many reasons, including:
• suffocation
• choking
• infections, such as pneumonia
• drowning
• diseases, such as emphysema, lung cancer, and lung
infections
• inhaling poisonous chemicals
• heart failure or a history of heart attacks
• allergic reactions
• general anesthesia
• sleep apnea
