Vital Signs Assessment Chapter 12 Vital Signs Assessment
Primary survey Establish Unresponsiveness Ask the victim “Are you OK?” If no response, active EMS Check CAB’s If not breathing, begin CPR Determine shock or hemorrhage Assess head toe for bleeding or trauma
The secondary survey Only begin the secondary survey once the athlete is deemed stable Begins with an assessment of vital signs Musculoskeletal Assessment DOCUMENT EVERYTHING!
Vital Signs Pulse rate Respiratory rate Blood pressure temperature Skin color Pupillary reaction Level of consciousness Movement in the extremities
The Pulse Reflects condition of patient’s circulatory system and cardiac function Pulse is found in the artery Vessel that carries blood away from the heart to the rest of the body Absence of a pulse indicates cardiac arrest or death
The Pulse Rate, rhythm and quality are assessed Rate: normal, abnormal Rhythm: regular, irregular Quality: weak, strong
The Pulse Normal pulse for adults is 60-80 beats per minute (bpm) Athlete’s may be 50-60 bpm
The Pulse Abnormal pulses indicate trauma Rapid & weak: shock, bleeding, diabetic coma, heat exhaustion Rapid and strong: heatstroke, fright Slow and strong: skull fracture, stroke No pulse: cardiac arrest, death.
The Pulse Higher than average pulse rates = tachycardia Lower than average pulse rates = bradycardia
The Pulse Can be found in 11 different places on the body Pulse points
The Pulse Radial Carotid Brachial Femoral Popliteal Posterior Tibial Dorsal pedal
The Pulse Use two fingers to measure pulse rate, rhythm, and quality NEVER USE THE THUMB – WHY?
The Pulse First beat measured is calculated as zero 10 sec x 6
Vital Signs Pulse rate Respiratory rate Blood pressure temperature Skin color Pupillary reaction Level of consciousness Movement in the extremities
Respiration Process of exchanging oxygen for carbon dioxide Takes place in the lungs Regulated by the brain and CO2 levels in the bloodstream Single respiration consists of one inspiration and one expiration
Respiration General guidelines for normal rates are: 15 years and older: 12-20 breaths per minute Well-trained athlete: 6-8 breaths per minute
Respiratory Patterns Abdominal – belly breathing Apnea – absence of breathing Tachypnea – rapid breathing Bradypnea – slow breathing Cheyne-Stokes respiration – pattern of rapid deep breathing followed by apnea
Respiratory Patterns Dyspnea – difficulty breathing Kussmaul’s breathing – hyperventilation Caused by too much CO2 in the blood Labored breathing – shown by using shoulders, neck, back muscles to breath
Measuring Respiration Respiratory rate & pattern are measured Count inhalations & exhalations Watch for chest rise & fall 30 sec x 2 = breaths per minute Describe pattern
Measuring Respiration Never tell the patient you are measuring their respiration Why?
Lung Volumes The volume of air associated with the phases of the respiratory Inhalation exhalation
Lung Volumes Total Lung Capacity (TLC) – the volume of the lungs at maximal inflation Tidal Volume (TV) – the volume of air moved in and out of the lungs during normal breathing
Lung Volumes Vital capacity (VC) – the volume of air breathed out after maximal inhalation Peak Expiratory Flow (PEF) – the highest forced exhalation measured with a peak flow meter
Peak Flow Meter Measures the highest volume of air a person can exhale Measured in liters per minute (L/min) Indicates airway function Used to monitor the effectiveness of medications (inhalers)
Peak Flow Meter
Using a PFM A baseline “personal best” is established over a 2-3 day period Measures are taken and compared to the baseline value
Using a PFM PEF>80% - person clear to workout without limitations 50%<PEF<80% - person should take medication to raise PEF; workout might need to be altered; person should be monitored closely PEF<50% - the person should be transported for emergency medical care
VITAL SIGNS Pulse rate Respiratory rate Blood pressure temperature Skin color Pupillary reaction Level of consciousness Movement in the extremities
Blood Pressure Measurement of pressure of the blood against walls of arteries Systolic & Diastolic measurements Systolic – heart contraction Top number Diastolic – heart relaxation Bottom number
Blood Pressure Affected by many factors Amount of blood in body Fluid levels (dehydration) Force of heartbeat Condition of the arteries
Blood Pressure Affected by many factors Age, exercise, sex, obesity, food, pain, stress, stimulants, steroids, medications can increase BP Weight loss, fasting, depression, blood loss can decrease BP
Blood Pressure Hereditary & genetic implications Exercise increases efficiency of the heart
Blood Pressure Blood pressure is measured in millimeters of Mercury (mm Hg) Normal blood pressure: Systolic = 115-120 mm Hg Diastolic = 75-80 mm Hg
Blood Pressure High blood pressure is hypertension (135/90) Cardiac problems or stroke Low blood pressure is hypotension (110/65) Hemorrhage, shock, heart attack, internal bleeding, dehydration
Blood Pressure
Blood pressure Measured with a sphygmomanometer and stethoscope Process known as auscultation
Measuring Blood Pressure Place cuff around upper arm, just above elbow Stethoscope head is placed in the antecubital fossa (crook of the elbow
Measuring Blood Pressure Inflate bulb to 180-200 mm Hg Open the valve to slowly deflate
Measuring Blood Pressure Listen for heart beat Whooshing noise First sound heard is systolic value Last sound heard is diastolic value
Blood Pressure
Measuring Blood Pressure http://www.youtube.com/watch?v=S648xZDK7b0
Temperature Measures thermal activity in the body Normal body temp is 98.6o F, 37o C
Temperature Elevated temperature (>99.1o) can be due to Disease, pain, fear, nerves Decreased temperature (<98.1o)can be due to Cold exposure, pain, fear, nerves Accompanied by chills, teeth chattering, blue lips (cyanosis) pale skin (pallor)
Temperature Measured at various sites Oral Axillary Tympanic Rectal Core temperature is reflected by skin temperature
temperature Process depends on method Sterilize thermometer Insert into mouth, ear drum, armpit Wait 30-90 sec Document reading