Vital Signs

Question 1

State Of Consciousness

Answer 1

• First sign assesed (LOC>ABC’s)
• Monitor throughout assessment:
  1. Alert
  2. Awareness of surroundings/environment
  3. Responsive to verbal or painful stimuli
• Head injury, heatstroke and diabetic coma affects LOC

Question 2

Pulse

Answer 2

• First vital taken
• @ radial/carotid artery w/ index & middle finger for minimal of 15 sec
• Compute pulse rate :
  1. normal
  2. tachy
  3. brady
• Record in appropriate place

Question 3

Pulse Quality

Answer 3

0 - No pulse
1 - Weak, fade in/out, easily obliterated w/ pressure
2 - Pulse difficult to palpate, may/may not obliterate w/ pressure >1
3 - Pulse easily palpable, doesn’t fade, normal
4 - Strong & bounding

Question 4

Pulse Rates

Answer 4

PATIENT BRADY NORMAL TACHY
Adult <60 60-80 100+

Child 80-100

Question 5

Respirations

Answer 5

Looks/Feel for rising/falling chest
Listen for breathing (nose/mouth)
Count respirations (30 sec x 2)

Question 6

Noting Breathing Quality

Answer 6

Normal = 12-20 bpm
Tachypnea = 20+ (panting)
Bradypnea = <12 (slow/deep)
Dyspnea = difficulty breathing
Apnea = cessation of breathing

Question 7

Breathing-type Observations (name 3)

Answer 7

• Cheyne-stokes: crytically ill, episodes of apnea w/ regular breathing
• stertorous breathing: terminal stages, rattly, snoring type
• shallow: shock, heat exhaustion, insulin shock, chest injury
• irregular: obstruction, diabetic coma, asthma, chest injury
• rapid: diabetic coma, hyperventilation
• frothy & bloody: lung damage (fx rib/object)
• slowed: stroke, head injury, chest, drugs
• wheezing: asthma
• no breathing: cardiac arrest/probs, hypoxia

Question 8

BP

Answer 8

• Patient is seated w/ dominant arm resting at heart level, elbow passively extended
• You are standing/seated at eye level to cuff
• Pick correct cuff size
• Cuff placed just proximal to cubital fossa with bladder over artery, gauge visible
• Stethoscope placed over brachial artery @ crease in arm, on medial side of cubital fossa (not under cuff)
• Close valve
• Inflate to 160-200
• Slowly release until tapping heart (systolic)
• Release until pulse is gone (diastolic)
• Record pressures and time taken
• Retake every 5-15 min noting increase/decrease

Question 9

Pupils

Answer 9

• Note athletes who normally have irregular pupils (in PPE)
• Make not of contact lenses (if present), access reaction rather than size
• PEARL

Question 10

In-clinic Assessment (1)

Answer 10

• Athlete lying or sitting
• Instruct athlete to look past shoulder
• Penlight on before eyes
• Shine 1-2 sec, then move (watching pupils)
• Constrict w/ light, dilate back to normal within 1-2 sec.
• Check opposite eye
• Record as PEARL

Question 11

On-field Assessment (2)

Answer 11

-Athlete lying/sitting
-Cover one eye w/ hand
-Covered eye dilates while uncovered remains same
-When hand removed, eye accomodates to light
*Note abnormalities/indications
(Fail to accomodate to light = brain inj, alcohol, drug poisoning)

Question 12

Temperature

Answer 12

• Types (electronic, bulb, tempadot)
• Measured under tongue, armpit, tympanic membrane, rectum
• Oral temp taken for 3 min (bulb)
• Bulb thermometer shaken down = 97 deg.
• Record to nearest tenth
• Note skin temp, color, moisture (red, white, blue)