Vital signs
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Vital signs are measures of various physiological statistics often taken by health professionals in order to assess the most basic body functions. Vital signs are an essential part of a case presentation.
Primary four
There are four vital signs which are standard in most medical settings:
The equipment needed is a thermometer, a sphygmomanometer, and a watch with a second hand.
Though a pulse can often be taken by hand, a stethoscope may be required for a patient with a very weak pulse.
Additional signs
Fifth sign
The phrase "fifth vital sign" usually refers to pain, as perceived by the patient on a Pain scale of 0-10. For example, the Veterans Administration made this their policy in 1999. However, some doctors have noted that pain is actually a subjective symptom, not an objective sign, and therefore object to this classification.[1]
Other sources include pulse oximetry as their fifth sign.[2][3][4]
Some sources consider pupil size, equality, and reactivity to light to be a vital sign as well.[5]
Sixth sign
There is no standard "sixth vital sign", and the use is much more informal and discipline-dependent than with the above, but some proposals (excluding the fifth sign candidates above) include:
- Urinary continence[6]
- End-tidal CO2[7]
- Emotional distress[8]
- Spirometry[9]
- Glucose[10]
- Functional Status[11]
- Oxygen saturation level
- Intracranial pressure
- Skin signs (color)
Variations by age
Children and infants have respiratory and heart rates that are faster than those of adults as shown in the following table:
| Age | Normal heart rate (beats per minute)[12] | Normal respiratory rate (breaths per minute)[13] |
|---|---|---|
| Newborn | 200-260 | 30-50 |
| 0-5 months | 90-190 | 25-40 |
| 6-12 months | 80-140 | 20-30 |
| 1-3 years | 80-130 | 20-30 |
| 3-5 years | 80-120 | 20-30 |
| 6-10 years | 70-110 | 15-30 |
| 11-14 years | 60-105 | 12-20 |
| 14+ years | 60-100 | 12-20 |
See also
References
- ↑ Harold S. Lee. November 2004. Physical Diagnosis 101: A Lesson From the First Year of Medical School, in Letters to the Editor. American Society of Anesthesiologists, Volume 68, Number 11.
- ↑ Mower W, Myers G, Nicklin E, Kearin K, Baraff L, Sachs C (1998). "Pulse oximetry as a fifth vital sign in emergency geriatric assessment". Acad Emerg Med 5 (9): 858-65. PMID 9754497.
- ↑ Mower W, Sachs C, Nicklin E, Baraff L (1997). "Pulse oximetry as a fifth pediatric vital sign". Pediatrics 99 (5): 681-6. PMID 9113944.
- ↑ Neff T (1988). "Routine oximetry. A fifth vital sign?". Chest 94 (2): 227. PMID 3396392.
- ↑ Daniel Limmer and Michael F. O'Keefe. 2005. Emergency Care 10th ed. Edward T. Dickinson, Ed. Pearson, Prentice Hall. Upper Saddle River, New Jersey. Page 212 and 218.
- ↑ Joseph A (2003). "Continence: the sixth vital sign?". Am J Nurs 103 (7): 11. PMID 12865635.
- ↑ Vardi A, Levin I, Paret G, Barzilay Z (2000). "The sixth vital sign: end-tidal CO2 in pediatric trauma patients during transport". Harefuah 139 (3-4): 85-7, 168. PMID 10979461.
- ↑ Bultz B, Carlson L (2006). "Emotional distress: the sixth vital sign--future directions in cancer care". Psychooncology 15 (2): 93-5. PMID 16444764. link
- ↑ http://www.ohsu.edu/medicine/residency/handouts/0405handouts/COPD091304.ppt
- ↑ http://www.medicine.uiowa.edu/cme/about/documents/PrintHandout.ppt
- ↑ Bierman A (2001). "Functional status: the sixth vital sign". J Gen Intern Med 16 (11): 785-6. PMID 11722694. link
- ↑ Emergency Care, Page 214
- ↑ Emergency Care, Page 215
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| On the job | Activities of daily living • Incident report • Vital signs |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
