At the completion of this chapter, the reader will be able to:
List the vital signs that are used to help determine a patient’s status
Explain the importance of monitoring each of the vital signs
Describe the signs and symptoms that would warrant an assessment of the vital signs
List some of the variables that can affect the accuracy of the vital signs
Describe the correct techniques to assess heart rate
Describe the correct techniques to assess respiration rate
Describe the correct techniques to assess blood pressure
Describe the correct techniques to assess temperature
List the various tools that are available for the assessment of pain
Describe how to respond to an emergency
The triad of pulse, respiration rate, and blood pressure is often considered as a baseline indicator of a patient’s health status, which is why each is called a vital or cardinal sign. All four practice patterns in the Guide to Physical Therapist Practice1 include measuring pulse, blood pressure, and respiration as a routine part of any physiologic examination. Temperature is not included because physical therapist assistants (PTA) do not routinely assess it. However, as a temperature can often provide an important clue to the severity of the patient’s illness, particularly the presence of infection, it is discussed in this chapter. Additional physiologic status measurements, which are not universally considered vital signs, include assessing perceived exertion ratings, pain, and pulse oximetry.
Clinical indicators that highlight the need to monitor vital signs include dyspnea, hypertension, fatigue, syncope, chest pain, irregular heart rate, cyanosis, intermittent claudication, nausea, diaphoresis, and pedal edema. Certain patient populations also warrant a vital sign assessment, including elderly patients (older than 65 years), very young patients (younger than two years), debilitated patients, patients with a history of physical inactivity, and patients recovering from a recent trauma. The measurement of vital signs can also assess a patient’s response to activity.
It is worth remembering that several variables can influence the results of the vital signs measurements. These include caffeine consumption, alcohol consumption, tobacco use, physical activity level, medications, and the use of illegal drugs.2 The other variables that can influence the results are outlined in Table 6-1.
TABLE 6-1Variables That Can Influence Vital Signs Data ||Download (.pdf) TABLE 6-1 Variables That Can Influence Vital Signs Data
Time of day
General health status
Pulse oximetry (Figure 6-1) is an important related measure, as it provides information on arterial blood oxygen saturation levels.
Pain is considered by many to be a vital symptom.3-12