How To Check for Vital Signs | What Vital Signs Mean

What are Vital Signs?

The human body is magnificently designed. Just like a high-performance race car, a trained individual can tell you what’s wrong with someone based on a standard diagnostics test just like the local technician at the local auto repair shop. For cars, it’s a diagnostic test. For people, it’s vital signs. The normal vital sign range can vary depending on many factors, such as age, overall health, environmental factors, etc. Infant vital signs and kids’ vital signs are higher or lower (depending on the vital sign being evaluated) than normal vital signs for adults.

Vital Signs Definition

Vital signs, also known as signs of life, are objective measurements that are able to be monitored, observed, or measured. When these vital signs are anything above zero, they indicate life. Firefighters, paramedics, police officers, military service members, medical professionals, and even dentists require a working knowledge of vital signs to provide a baseline indication of health.

Why do we check for Vital Signs?

Whenever you go to a hospital, emergency clinic, doctor’s officer, or even the dentist one of the staff check your “vitals.” The purpose of this is to establish a baseline which in turn enables the nurse, doctor, physician assistant, etc. to identify any irregularities and begin developing a solution to your ailments. Even if you’re perfectly healthy and merely visiting the doctor for a yearly checkup, your doctor may tell you to watch your blood pressure based upon a change in the last baseline vitals during your previous visit. Later, we’ll get into how to take vital signs.

What are the six Vital Signs?  

While medical professionals agree on four signs as standard, specialized care facilities may use up to six measurable traits.

1. Body Temperature
2. Heart Rate or Pulse
3. Respiratory Rate
4. Blood Pressure
5. Pain Scale (most commonly used)
   1. Menstrual Cycle
   2. Pulse Oximetry
   3. Blood Glucose Levels
6. Shortness of Breath
   1. Functional Status
   2. End-tidal CO2
   3. Gait Speed

Body Temp

Body temperature, or thermoregulation if you want to impress your friends, is your body’s ability to regulate its own temperature. You sweat in hot weather and shiver in cold weather because your body is attempting to self-regulate your temperature within an acceptable range. This acceptable range varies by person, but the generally accepted range for a healthy adult is between 97.6 and 99.6 degrees Fahrenheit. Babies and children have a slightly higher range, between 97.9 to 100.4 degrees Fahrenheit.

For most of us, a low body temperature (hypothermia) likely indicates an overexposure to the elements in cold temperatures or water immersion. Your body shivers to vibrate your muscles and increase exothermic activity in your muscle’s cells, in turn generating heat while staying still in an effort to reach your norm temperature. Drug and alcohol use, a hypoactive thyroid, and any number of infections can also explain a consistently low body temperature.

The causes of high body temperatures (hyperthermia) can be anything from over bodily exertion to your body fighting off infection. In fact, many medical professionals believe you develop a fever to burn up the infection as a natural defense. When you’re mowing the grass on a hot Texas summer day or hiking Pike’s Peak in Colorado during a light snow, you’re likely sweating. This is the body’s most common way to regulate your temperature by cooling your skin down.

If someone’s body temp falls below 95 degrees Fahrenheit or is above 103 degrees Fahrenheit, seek medical attention immediately. These are considered deadly body temps and indicates that the body can no longer regulate its own temperature.

Here’s a quick study guide for treating life-threatening hypothermia:

https://www.armystudyguide.com/content/powerpoint/First_Aid_Presentations/identify-and-treat-cold-w-2.shtml

And another guide for treating hyperthermia:

https://www.armystudyguide.com/content/powerpoint/First_Aid_Presentations/heat-injuries-2.shtml

To check for body temp, you can use a number of different tools. We recommend maintaining a glass or electric thermometer for oral use at home. The special thermometers your doctor uses in your ear are quite accurate because they give a better indication of the body’s core temperature. You can improvise and use a glass thermometer in someone’s armpit, but keep in mind that it may be up to half a degree higher than a typical oral reading. The Ranger Instructor Special, or rectal temperature, will also measure anywhere from half a degree to 0.7 degrees Fahrenheit higher than an oral reading.

Pulse Rate

The pulse rate, more commonly known as heart rate, is essentially the rate at which you can feel your heart pumping blood through your body. The pulse rate is a good way to help measure the heart’s efficiency. To get a good tactile reading on the pulse rate, you need to find an artery close to the skin’s surface. The easiest arteries to check are the carotid artery (on your neck just below your jaw) and the radial artery (on the wrist below the palm of your hand). You can also use the femoral artery (groin), popliteal artery (behind your knee), the posterior tibial artery (near the ankle joint), and the dorsalis pedis artery (on top of your foot). You can use any of these places to check for pulse rates by holding one of these particular areas with your fingertips and counting how many beats you feel per minute.

Here’s a normal pulse range chart correlating age with the average pulse range (BPM= Beats Per Minute):

Many factors affect the normal pulse range, such as activity level, fitness level, air temperature, body position during measurement, emotions, body size, and medications. Keep in mind that all measurements are generally taken at rest. A normal pulse range for a healthy adult ranges anywhere from 60-100 beats per minute, but a well-trained athlete might be closer to 40 beats per minute.

Generally speaking, a high resting pulse rate can mean inactivity or poor fitness that’s indicative of a sedentary lifestyle. Conversely, a low resting heart rate indicates an active, fitness-centric lifestyle.  Outliers do exist, so please consult a doctor if your resting heart rate is unusually outside of the normal adult pulse of 40-60 beats per minute.  

If you have access to clinical resources, you can use high tech machines to accurately read the pulse rate. The most common is the electrocardiograph machine or EKG. EKGs measure much more than just heart rate, but it is a very accurate method. Most of us do not have access to these machines, so we must rely on a simple watch or timer and the tactile sense in our fingers. To do this in a field environment, use your bare fingertips to feel the pulse on exposed skin at one of the areas discussed above. Locate the pulse and feel a few beats prior to starting your timer. Keep your eyes on your watch and fingers on the skin, then count the beats until one minute elapses. Certain conditions, such as extreme cold or hypothermia, may not allow for taking a pulse reading on extremities. For extreme cases like this, measure the heart rate as close to the heart as possible.

Respiration Rate

Simply the amount of normal breathes per minute your body takes to intake oxygen and offload carbon dioxide. Below is a chart representing the normal respiratory rate based on age. Note that the adult respiratory rate is significantly lower than newborns. In this instance, BPM= Breathes Per Minute.

As noted above, your normal breathing rate should be somewhere between 12-20 breathes per minute. Irregularities in your normal respiration, such as shortness of breath, are potentially life-threatening. Changes in your average respiration rate can indicate dangerous causes such as heart attack, pneumonia, or a pulmonary embolism. These symptoms require medical attention immediately. More common causes of high respiration are exercise, exertion, or stress. For some of the common causes, you will return to your normal breaths per minute after a (hopefully) short break.

Common causes of low respiration rates are head injuries, hypothermia, COPD (chronic obstructive pulmonary disease), asthma, and diabetes. Drugs can also significantly lower your average respiratory rate.

To check for the respiration rate on a patient, simply observe the number of breaths taken within a minute. Cold weather will help see the breath, but if you’re in a situation where you can’t see the breath itself, you can either observe the chest rising, feel the breath with your exposed skin, or hover your ear over the patient’s mouth to both feel and hear the breath count. Once the minute is up, compare the patient’s breath with the chart above to see if it falls into the normal respiratory rate.

Blood Pressure

This is the pressure of circulating blood within your blood vessels. Here is a chart showing the minimum, maximum, and normal blood pressure for infants to seniors.

High blood pressure, also known as hypertension, occurs when blood moves through arteries at a higher pressure than normal. Hypertension can put you at risk for stroke, heart disease, heart attack, and kidney failure. Conversely, low blood pressure (hypotension) is lower than normal pressure in your arteries. This is usually not considered dangerous unless noticeable symptoms are present such as dizziness and fainting. However, when these symptoms are present they can indicate serious heart, endocrine, or neurological disorders.

Blood pressure is checked with a few different methods, but most readings are given in systolic pressure (maximum pressure during one heartbeat) over diastolic pressure (minimum pressure during one heartbeat). One of the most common readings is gathered using a sphygmomanometer and a stethoscope. A manual sphygmomanometer uses the height of a column of mercury to reflect the circulating pressure in your arteries, but electronic ones are also available. The electronic ones are simple, but more expensive, since you simply snuggly place it on your bicep, turn it on, and wait for the reading. The manual version requires more work but is still fairly accurate.

Here’s how to use a manual sphygmomanometer and a stethoscope:

1. Sit in a chair with a place to support your testing arm (generally your left arm). Your arm should be approximately the same height as your heart when extended with a slight bend in your elbow.
2. Wrap the cuff around your testing arm. Ensure to remove any garments and get skin to cuff contact. It should fit snugly on your arm.
3. Place the wide head of the stethoscope flat against your skin on your inner arm on your brachial artery. The edge of the stethoscope should be just beneath the cuff.
4. Place the earpieces of the stethoscope in your ears.
5. Clip the pressure gauge to a stable surface so that you can see the needle and pressure markings.
6. Tighten the valve on the rubber bulb. Twist the valve clockwise until you feel it stop.
7. Rapidly inflate the cuff to 180mmHg. This temporarily cuts off the blood flow to get an accurate reading.
8. Gently turn the bulb valve counter-clockwise to release the pressure. Keep an eye on the needle and try to keep it moving downwards at a rate of 3mm per second.
9. As the pressure drops, note your systolic pressure. When you hear the first thump in your earpieces, the pressure reading on the gauge is your systolic pressure.
10. Once you stop hearing thumping or whooshing noises in your earpieces, note the reading on the gauge. This is your diastolic blood pressure.

Adult and Pediatric Vital Signs Chart

*Respiratory Rate is given in Breaths Per Minute

**Heart Rate is given in Beats Per Minute