Vital signs
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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
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
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
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 |
References
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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