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 Pulse  Respiration  Temperature  Blood pressure  Pupils  Colors  Level of consciousness  Reaction to pain  Ability to move A-2

 Reflects the rate of heart beats.  Felt when an artery passes over a bone. near body surface.  Pulse check on both arms.  Feel for: force and rhythm. A-3

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1- Radial: artery of the wrist, below the thumb. 2- Carotid: in groove created by windpipe and large muscle in the neck. Commonly used in CPR. 3 - Temporal: in front of the ear. 4 – Femoral: near the groin. 5 – Brachial: located on the inside of upper arm. Used in infant during CPR. 6– Dorsalis pedis: over the dorsum of the foot. A-5

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 Pulse Points Temple College EMS Program7 Carotid Brachial Radial Femoral Popliteal

A-8 Alternatively find the carotid pulse. Alternatively find the carotid pulse. Alternatively find the carotid pulse.

 Pulse Points Temple College EMS Program9 Dorsalis Pedis Posterior Tibia (Posterior and slightly inferior to medial Malleolus)

 Normal heart rate: 60 – 100/ minute.  Regular in rate and rhythm, strong to touch.  Tachycardia: Fast heart rate > 100/minute.  Causes: exercise, infection, excitement, shock, heart attack.  Bradycardia: Slow heart rate < 60/minute.  Causes: sleep, rest, overdose of certain drugs, hypoxia. A- 10

 Normal respiratory rate is 12 – 16 /minute.  Tidal volume ( air breathed in ) is 500 ml  Hyperventilation: increased respiratory rate.  Occurs during exercise, infection, emotional stress, shock.  Hypoventilation: decreased respiratory rate.  Occurs during sleep, overdose of certain drugs.  Apnoea: cessation of breathing. A- 11

 Average body temperatures is 37 C.  Hypothermia: low temperature  Occurs in severe loss of body fluids through excessive vomiting, diarrhea, bleeding, shock.  Hyperthermia: high temperature  Occurs as a result of infection, heat illness, injuries. A- 12

 Mouth: for one minute  Axilla: for four minutes.  Rectally: for two minutes.  Skin: using a special scale or feeling by the hand. A- 13

 Definition: pressure (force) exerted on the wall of the artery by the blood. A- 14

 Systolic: the force to pump blood out of the heart.  Diastolic: resting period when pressure falls.  Normal blood pressure:  120/80 – 100/70. A- 15

 Hypertension: high blood pressure.  Occurs in atherosclerosis, obesity, increasing age,exercise.  Hypotension: low blood pressure.  Occurs in fluid loss in vomiting, diarrhea, shock, bleeding. A- 16

 Place the patient in a position of comfort.  Support the bared arm, avoid constriction of arm.  Apply the cuff firmly.  Cuff should be approximately 2.5 cm above antecubital fossa. A- 17

sphygmomanometer,sphygmomanometer a device used for measuring arterial pressure(MERCURY)  Stethoscope.  Cuff. A- 18

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 Examine both eyes.  Check pupils for size, equality and responsiveness  Normal: equal, and reactive to light.  Constricted unresponsive: CNS disease, narcotics e.g. heroin, morphine.  Dilated unresponsive: Cardiac arrest. Unequal: in stroke, head injury.

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 Normal healthy flushing after pressing for few seconds on skin, ear lobes, tip of fingers.  Pale skin: in severe bleeding, shock, hypotension.  Cyanosis (blue ): due to hypoxia, airway obstruction, heart failure.  Pink coloration: carbon monoxide poisoning.  Yellow coloration (jaundice): in hepatitis, hemolytic anemia, obstructive jaundice. A- 29

Used to assess responsiveness during:  Cardiac arrest,  Head injuries,  Comatose patients A- 30

Response can be tested by:  1-Pinching the earlobe  2-Pressing over the eye brow  3-Rubbing the sternum  4-Using a pin or sharp object. A- 31

Assessed if the patient is conscious, with no evidence of injury to extremities, and suspected spinal injury. Both sides are tested.  Upper extremities Ask patient to grasp your hand.  Lower extremities Ask patient to press sole of his foot against your hand. A- 32

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