1. Vital Signs Signs of life

2. Vital signs: 1. Temperature - T 2. Pulse – HR (heart rate)
3. Respirations – RR (respiration rate)
4. Blood pressure - BP
5. Pain level on a scale 1-10
6. Oxygen saturation – O2SAT

3. What can vital signs tell us?

4. Regulatory center - Hypothalamus
Temperature
Regulatory center - Hypothalamus

5. Core temperature 36.8±0.7 °C, or 98.2±1.3 °F 97.6 – 99.6 per Hartman
Oral – mouth
Rectal – rectum
Tympanic – ear
 36.8±0.7 °C, or 98.2±1.3 °F
97.6 – 99.6 per Hartman

6. Celsius vs. Fahrenheit
36.8±0.7 °C

7. Fahrenheit
98.2±1.3 °F

10. Circadian rhythm
Normal body temperature may differ as much as 0.5 °C (1.0 °F) from day to day.
The lowest temperature occurs about two hours before the person normally wakes up

11. Oral temperature
Oral temperatures are influenced by drinking, chewing, smoking, and breathing with the mouth open. Cold drinks or food reduce oral temperatures; hot drinks, hot food, chewing, and smoking raise oral temperatures

12. Wait to take oral T for 10-20 min
If patient just chewed gum, ate, smoke, or had hot or cold drink

13. Oral temperature
Do not take an oral temperature on a confused patient.
Why?
Facial trauma
Using O2
Just had cold or hot drink
Younger than 6 years old
Why do you think the tympanic (ear) thermometer is a preferred method of taking temperature at health care facilities?

14. Research on oral T National Institute of Health – NIH:
pubmed/
Read a conclusion, discuss the trustworthiness of the research article.

15. Tympanic temperature

16. Rectal temperature

17. Rectal temperature
Insert a thermometer ½ to 1 inch into rectum and hold onto thermometer at all times.
Why?

18. Rectal thermometers for the home use

19. Rectal vs. Oral Probe Rectal probe/thermometer is red
Oral probe/thermometer is blue

20. Fertility Rectal Temperature Application Ovulation and pregnancy cycle:

21. Ovulation and pregnancy cycle:

22. No ovulation cycle

23. Auxiliary temperature (Ax)
Hold a glass thermometer in underarm space for 5 min
Hold an electronic thermometer till the beep

24. (Ax)
Good alternative for rectal on kids, but you need to convert it to rectal, since Ax is much lower as core temperature

25. Sliding thermometer against temporal artery
Temporal Temperature
Sliding thermometer against temporal artery
Safe and easy

26. Medical research hasn't determined an exact correlation between oral, rectal, ear, armpit, and forehead temperature measurements. Generally, the correlation of temperature results are as follows:
The average normal oral temperature is 98.6°F (37°C).
A rectal temperature is 0.5°F (0.3°C) to 1°F (0.6°C) higher than an oral temperature.
An ear (tympanic) temperature is 0.5°F (0.3°C) to 1°F (0.6°C) higher than an oral temperature.
An armpit (axillary) temperature is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature.
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature.

27. Charting Temperature
36.6° C (O)
98.8° F (Ax)
101.3° F (R)
37.5° C (T)

29. Oxygen Saturation – O2Sat
Normal range %
Measuring O2SAT
Oximetry

30. Respiration Rate- RR Normal rate 12-20
Patients shouldn’t know when you start counting their RR, because they can start breathing either too slow or too fast.
Keep your fingers on radial pulse, pretending that you counting pulse, but count respirations instead (in real life, but not for the state test)

31. Cardiovascular VS – HR and BP
Anatomy and physiology
Intro to anatomy of the heart
Visible Body.
Cardiologist explains heart anatomy 4

32. Khan Academy
Khan academy – Meet the Heart!
Homework – Khan academy:
Layers of the heart,
Lub Dub,
Flow through the heart
Activity – Draw a heart with four chambers, identify four valves, and eight major vessels. Option for extra credit – make heart out of clay.

33. Pulse – Heart Rate - HR Normal range – 60-100 beats per minute - bpm
Note rate, rhythm, and strengths

34. Homework
Advanced Circulatory System Physiology in Khan Academy: Health and Medicine
/science/health-and- medicine/circulatory-system
ch?v=QXckE_DlFAM
What is blood pressure? 6
h?v=J97G6BeYW0I
For Christmas potluck – one documentary and one movie about medicine and health related isssues

35. Rate Fast Slow Tachycardia HR above 100 bpm Bradycardia
HR below 60 bpm

36. Rhythm
Regular
Irregular

37. Strength
Strong = normal
Weak

38. Activity
Find pulses on yourself.

39. Radial Pulse

40. Check apical pulse on yourself
Activity
Check apical pulse on yourself

41. Pulse deficit and A-Fib
Pulse deficit is the difference between the heart rate and the palpable pulse, as is often seen in atrial fibrillation.
Atrial fibrillation or A-Fib is the most common abnormal heart rhythm. It may cause no symptoms, but is often associated with palpitations, fainting, chest pain, or congestive heart failure.

42. Resting Heart rate
Your resting heart rate refers to the body's lowest heart rate, when your body is close to absolute rest, such as upon awakening in the morning. 
Lowering your resting heart rate can significantly reduce your risk of heart attack and stroke and increase your endurance and feelings of well-being.

43. Resting Heart rate
Knowing your resting heart rate can help you to assess your overall health and condition and help you set heart rate targets.
Fitted athlete's heart rate is per minute

44. Maximum heart rate
Maximum heart rate. This is the highest your pulse rate can get. To find yours, follow this formula: 220-(your age)=(predicted maximum heart rate)

45. Target heart rate
Target heart rate. This is 60 to 85 percent of your maximum heart rate. This is usually accomplished through exercise.

46. Why do I care for target heart rate?
If your heart rate is lower than a target rate, then this exercise is good for flexibility or strength training, but wouldn’t train your heart.
Aerobic exercise are the ones which train the heart

47. Diversify your exercise
To train
Strength - ?
flexibility - ?
heart - ?

48. Diversify your exercise
To train
Strength - ?
flexibility - ?
heart - ?

49. Diversify your exercise
To train
Strength - ?
flexibility - ?
heart - ?

50. Diversify your exercise
To train
Strength - ?
flexibility - ?
heart - ?

51. Blood Pressure
You need –
Stethoscope
Sphygmomanometer
Alcohol pads

52. BP – Blood Pressure
Measures in mm of mercury – mm Hg due to old sphygmomanometer mercury type:

53. Blood Pressure 110/70
Systolic Blood Pressure – the top (first) number – the pressure in the heart during systole – the squeezing phase
Diastolic blood pressure – the bottom (second) number – the pressure during the relaxation phase of the heart diastole – shows the resistance in the vessels of the body

54. Normal range for BP
Systolic – absolute normal. In your book –
pre hypertension, (New 2017 NIH standards) old ones - 140)
above 130 – HTN (New 2017 NIH standards – 130, old ones in your book is 140)
Diastolic below 80 - absolutely normal, in your book – range is mm Hg
80-90 pre HTN
Above 90 – HTN

55. BP summary
Systolic/Diastolic
mm Hg/ mm Hg
Average human BP 110/70

56. Khan Academy
Advanced Circulatory System Physiology in Khan Academy: Health and Medicine
medicine/circulatory-system
What is blood pressure? 6

57. Blood pressure (Korotkoff) sounds
Youtube practice reading numbers:
Youtube practice reading numbers: %3A%2F%2Fwww.youtube.com%2Fresults%3Fsearch_quer y%3Dblood%2Bpressure%2Bsounds%26oq%3Dblood%2Bp res

58. Hypertension Nucleus – medical media 5
preview?ccat=all&clang=English&animationid=76622

59. Activity – measure BP