Patient Health Assessment and Vital Signs Flashcards
General Survey
“overall review”/”first impression”. Appearance, posture, verbal/ non-verbal communications, and behaviors. Look, listen, smell, observe.
A head-to-toe physical examination.
- Inspection (collecting visual cues, e.g., watching for non-verbal expressions or assessing physical movements during patient interactions)
- Auscultation (listening with a stethoscope, e.g., listening over the brachial artery for Korotkoff sounds)
- Palpation (using the pads of the fingertips to gently press on the anterior wrist, proximal to the base of the thumb, to detect the radial pulse).
Patient health history
To understand the state of the patient. Biographical data, reason for seeking care, past history, family history, psycho-social history, spiritual health.
Vital signs
Core temp, pulse, BP, respiratory rate, oxygen saturation and pain score.
Introducing yourself
- Name and role
- Confirm DOB and name
- Explain the procedure
- Gain consent
- Ask about pain from a scale of 0-10.
Primary Survey
Detecting immediate threat to life. Danger, Response, Send for help, Airway, Breathing, Circulation, Defibrillation.
Secondary Survey
History focused and physical exam after the primary survey. Focuses on the specific injury or medical complaint.
Measuring Pulse rate
- Measure full 60 seconds
- <60bpm, Bradycardia , wide range of aetiologies (e.g. atrioventricular block, medications).
- > 100 bpm is known as tachycardia and also has a wide range of aetiologies (e.g. anxiety, supraventricular tachycardia, hypovolaemia, hyperthyroidism).
- Typically lower in athletic individuals.
Measuring Respiratory rate
- While still doing the pulse, observe the breaths of the patient.
- Note any asymmetries in the expiratory and inspiratory phases of respiration (e.g. the expiratory phase is often prolonged in asthma exacerbations and in patients with COPD).
- For 60 seconds
- < 12 breaths per minute is referred to as bradypnoea (e.g. related to opiate overdose).
- > 20 breaths per minute is referred to as tachypnoea (e.g. related to acute asthma).
Measuring blood pressure
- First feel the pulse and find an estimate systolic number.
- Place stethoscope over the brachial artery
- re-inflate 20-30 mmHg over the estimate systolic.
- Begin to slowly deflate, the first pulsatile noise/ Korotkoff sound is the accurate systolic number.
- last sound is referred to as the 5th Korotkoff sound and this is the diastolic blood pressure.
Measuring the temp
Using the Tympanic thermometer.
Measuring oxygen saturation
- Use pulse oximeter
- Note whether the patient is on supplemental oxygen or breathing room air.
- When on nail ensure no nail varnish or dirt is covering the nail.
Infant vitals
- Sys BP 70-95
- Dia BP 50-70
- Pulse 120-160
- Respiratory 30-50
- Temp 35.5-37.5
Child vitals
- Sys BP 80-110
- Dia BP 50-80
- Pulse 75-100
- Respiratory 20-30
- Temp 36.5-37.0
Adult vitals
- Sys BP 100-140
- Dia BP 60-90
- Pulse 60-100
- Respiratory 12-20
- Temp 36.0-37.5
