Vital signs (also known as vitals) are a group of the four to six most crucial medical signs that indicate the status of the body's vital (life-sustaining) functions. These measurements are taken to help assess the general physical health of a person, give clues to possible diseases, and show progress toward recovery. The normal ranges for a person's vital signs vary with age, weight, gender, and overall health.

There are four primary vital signs: body temperature, blood pressure, pulse (heart rate), and breathing rate (respiratory rate), often notated as BT, BP, HR, and RR. However, depending on the clinical setting, the vital signs may include other measurements called the "fifth vital sign" or "sixth vital sign."

Early warning scores have been proposed that combine the individual values of vital signs into a single score. This was done in recognition that deteriorating vital signs often precede cardiac arrest and/or admission to the intensive care unit. Used appropriately, a rapid response team can assess and treat a deteriorating patient and prevent adverse outcomes.

Primary vital signs

There are four primary vital signs which are standard in most medical settings:

  1. Body temperature
  2. Heart rate or Pulse
  3. Respiratory rate
  4. Blood pressure

The equipment needed is a thermometer, a sphygmomanometer, and a watch. Although a pulse can be taken by hand, a stethoscope may be required for a clinician to take a patient's apical pulse.

Temperature

Temperature recording gives an indication of core body temperature, which is normally tightly controlled (thermoregulation), as it affects the rate of chemical reactions. Body temperature is maintained through a balance of the heat produced by the body and the heat lost from the body.

thumb|Oral glass thermometer showing a body temperature in °F

Temperature can be recorded in order to establish a baseline for the individual's normal body temperature for the site and measuring conditions.

Temperature can be measured from the mouth, rectum, axilla (armpit), ear, or skin. Oral, rectal, and axillary temperature can be measured with either a glass or electronic thermometer.

The main reason for checking body temperature is to solicit any signs of systemic infection or inflammation in the presence of a fever. Fever is considered temperature of or above. It may also be called "heart rate". In addition to providing the heart rate, the pulse should also be evaluated for strength and obvious rhythm abnormalities. A child aged 1–⁠3 years old can have a heart rate of 80–⁠130 bpm, a child aged 3–⁠5 years old a heart rate of 80–⁠120 bpm, an older child (age of 6–10) a heart rate of 70–⁠110 bpm, and an adolescent (age 11–⁠14) a heart rate of 60–105 bpm. In contrast to the traditional vital signs, these measurements are not useful for assessing acute changes in state because of the rate at which they change; however, they are useful for assessing the impact of prolonged illness or chronic health problems.

The definition of vital signs may also vary with the setting of the assessment. Emergency medical technicians (EMTs), in particular, are taught to measure the vital signs of respiration, pulse, skin, pupils, and blood pressure as "the 5 vital signs" in a non-hospital setting.

Fifth vital signs

The "fifth vital sign" may refer to a few different parameters.

  • Pain is considered a standard fifth vital sign in some organizations, such as the U.S. Veterans Affairs. Pain is measured on a 0–⁠10 pain scale based on subjective patient reporting and may be unreliable. Some studies show that recording pain routinely may not change management.
  • Menstrual cycle
  • Oxygen saturation (as measured by pulse oximetry)
  • Blood glucose level

Sixth vital signs

There is no standard "sixth vital sign"; its use is more informal and discipline-dependent.

  • End-tidal CO2|
  • Functional status
  • Shortness of breath
  • Gait speed
  • Delirium

Variations by age

{|class="wikitable"

|+ Reference ranges for blood pressure

|-

!rowspan=2| Stage !!rowspan=2| Approximate age !!colspan=2| Systolic !!colspan=2| Diastolic

|-

! Range || Typical example || Range || Typical example

|-

! Infants

| 1 to 12 months || 75-100 || 85 || 50–70 || Typical example || Range || Typical example

|-

!Newborn

| 100–160 || 130 || 30–50 || 40

|-

!0–5 months

| 90–150 || 120 || 25–40 || 30

|-

!6–12 months

| 80–140 || 110 || 20–30 || 25

|-

!1–3 years

| 80–130 || 105 || 20–30 || 25

|-

!3–5 years

| 80–120 || 100 || 20–30 || 25

|-

!6–10 years

| 70–110 || 90 || 15–30 || 20

|-

!11–14 years

| 60–105 || 80 || 12–20 || 16

|-

!15–20 years

| 60–100 || 80 || 12–30|| 20

|}

Monitoring

Monitoring of vital parameters most commonly includes at least blood pressure and heart rate, and preferably also pulse oximetry and respiratory rate. Multimodal monitors that simultaneously measure and display the relevant vital parameters are commonly integrated into the bedside monitors in intensive care units, and the anesthetic machines in operating rooms. These allow for continuous monitoring of a patient, with medical staff being continuously informed of the changes in the general condition of a patient.

While monitoring has traditionally been done by nurses and doctors, a number of companies are developing devices that can be used by consumers themselves. These include Cherish Health, Scanadu and Azoi.

See also

  • Biotelemetry
  • Medical record
  • Remote patient monitoring

References

fr:Signes vitaux