Vital signs

There are four primary vital signs which are standard in most medical settings: • Body temperature • Heart rate or Pulse • Respiratory rate • Blood pressure The equipment needed is a thermometer, a sphygmomanometer, and a watch. Although a pulse can be taken by hand, a stethoscope may be required for a clinician to take a patient's apical pulse. Temperature Temperature recording gives an indication of core body temperature, which is normally tightly controlled (thermoregulation), as it affects the rate of chemical reactions. Body temperature is maintained through a balance of the heat produced by the body and the heat lost from the body. Temperature can be recorded in order to establish a baseline for the individual's normal body temperature for the site and measuring conditions. Temperature can be measured from the mouth, rectum, axilla (armpit), ear, or skin. Oral, rectal, and axillary temperature can be measured with either a glass or electronic thermometer. The main reason for checking body temperature is to solicit any signs of systemic infection or inflammation in the presence of a fever. Fever is considered temperature of or above. It may also be called "heart rate". In addition to providing the heart rate, the pulse should also be evaluated for strength and obvious rhythm abnormalities. A child aged 1–⁠3 years old can have a heart rate of 80–⁠130 bpm, a child aged 3–⁠5 years old a heart rate of 80–⁠120 bpm, an older child (age of 6–10) a heart rate of 70–⁠110 bpm, and an adolescent (age 11–⁠14) a heart rate of 60–105 bpm. An adult (age 15+) can have a heart rate of 60–100 bpm. Respiratory rate Average respiratory rates vary between ages, but the normal reference range for people age 18 to 65 is 16–20 breaths per minute. The value of respiratory rate as an indicator of potential respiratory dysfunction has been investigated but findings suggest it is of limited value. Respiratory rate is a clear indicator of acidotic states, as the main function of respiration is removal of CO2 leaving bicarbonate base in circulation. Blood pressure Blood pressure is recorded as two readings: a higher systolic pressure, which occurs during the maximal contraction of the heart, and the lower diastolic or resting pressure. In adults, a normal blood pressure is 120/80, with 120 being the systolic and 80 being the diastolic reading. Usually, the blood pressure is read from the left arm unless there is some damage to the arm. The difference between the systolic and diastolic pressure is called the pulse pressure. The measurement of these pressures is now usually done with an aneroid or electronic sphygmomanometer. The classic measurement device is a mercury sphygmomanometer, using a column of mercury measured off in millimeters. In the United States and UK, the common form is millimeters of mercury, while elsewhere SI units of pressure are used. There is no natural 'normal' value for blood pressure, but rather a range of values that on increasing are associated with increased risks. The guideline acceptable reading also takes into account other co-factors for disease. Therefore, elevated blood pressure (hypertension) is variously defined when the systolic number is persistently over 140–160 mmHg. Low blood pressure is hypotension. Blood pressures are also taken at other portions of the extremities. These pressures are called segmental blood pressures and are used to evaluate blockage or arterial occlusion in a limb (see Ankle brachial pressure index). == Other signs ==

In the U.S., in addition to the above four, many providers are required or encouraged by government technology-in-medicine laws to record the patient's height, weight, and body mass index. In contrast to the traditional vital signs, these measurements are not useful for assessing acute changes in state because of the rate at which they change; however, they are useful for assessing the impact of prolonged illness or chronic health problems. The definition of vital signs may also vary with the setting of the assessment. Emergency medical technicians (EMTs), in particular, are taught to measure the vital signs of respiration, pulse, skin, pupils, and blood pressure as "the 5 vital signs" in a non-hospital setting. Fifth vital signs The "fifth vital sign" may refer to a few different parameters. • Pain is considered a standard fifth vital sign in some organizations, such as the U.S. Veterans Affairs. Pain is measured on a 0–⁠10 pain scale based on subjective patient reporting and may be unreliable. Some studies show that recording pain routinely may not change management. • Menstrual cycle • Oxygen saturation (as measured by pulse oximetry) • Blood glucose level Sixth vital signs There is no standard "sixth vital sign"; its use is more informal and discipline-dependent. • End-tidal CO2| • Functional status • Shortness of breath • Gait speed • Delirium == Variations by age ==

Children and infants have respiratory and heart rates that are faster than those of adults as shown in the following table : ==Monitoring==

Monitoring of vital parameters most commonly includes at least blood pressure and heart rate, and preferably also pulse oximetry and respiratory rate. Multimodal monitors that simultaneously measure and display the relevant vital parameters are commonly integrated into the bedside monitors in intensive care units, and the anesthetic machines in operating rooms. These allow for continuous monitoring of a patient, with medical staff being continuously informed of the changes in the general condition of a patient. While monitoring has traditionally been done by nurses and doctors, a number of companies are developing devices that can be used by consumers themselves. These include Cherish Health, Scanadu and Azoi. == See also ==