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VITAL SIGNS
Indicators to distinguish between living
and non living human being
 These are signs used by nurses, paramedics and
physicians to follow-up the patient's condition or
to detect any variation in them.
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The vital signs include:
 Pulse
 Respiration
 Temperature
 Blood pressure
 Pupils
 Colors
 Level of consciousness
Stroke pain
 Ability to move
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PULSE
 Reflects the rate of the heart beat
 Felt where an artery passes over a bone near the
surface (superficial) of the body.
 Normal heart rate (HR) ranges between 60-100
beats/min
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RESPIRATION
 It is the means by which oxygen enters the blood through
the lungs during breathing in (inspiration) and carbon
dioxide is expelled during breathing out (expiration).
 Normal respiratory rate (RR) is 12-20 breath/min
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TEMPERATURE
 Average body temp is 37 degrees centigrade
(normal temp.36.5-37.2 C°)
 Taken by a clinical thermometer
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BLOOD PRESSURE (BP)
 It means the force required by the heart to pump blood into the
arteries. It is measured in systolic and diastolic pressure.
 Systolic- is known as the force exerted by the heart to overcome the
resistance in the blood vessels. to pump blood out of the heart
(during contraction = systole)
 Diastolic- is known as the force exerted by the heart to overcome the
resistance if the vessels during resting period of the heart when the
pressure falls, also known as the relaxation period of the heart pump
 Normal B.P.
120/80 mm/Hg
 Hypertension: High blood pressure if BP < 140/90 mmHg.
 Hypotension : Low blood pressure if BP > 100/60 mmHg.
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PUPILS
 Check the pupils for size, equality and reactivity to
light (both pupils constricted)
 Examine both eyes
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COLOUR
 Color of
the skin and mucous membrane,
(conjunctiva, inside of the lips)
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LEVEL OF CONSCIOUSNESS
 This is used during cardiac arrest, head injuries and any comatose patient to
assess responsiveness
Terms Used to Describe Level of Consciousness
■ Alert: Follows commands in a timely fashion.
■ Lethargic: Appears drowsy, may drift off to sleep during
examination.
■ Stuporous: Requires vigorous stimulation (shaking,
shouting) for a response.
■ Comatose: Does not respond appropriately to either
verbal or painful stimuli.
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How to assess level of
consciousness LOC ??!!
The Glasgow Coma Scale (GCS) provides a more
objective way to assess the patient’s LOC. It evaluates
best eye response, best motor response, and best verbal
response on a scale of 3 to 15. Fifteen (highest score)
indicates that the patient is awake, alert, oriented, and
able to follow simple commands. Three (lowest score)
indicates that the patient does not respond to any
stimulus and has no motor or eye response, reflecting
a very serious neurologic state with poor prognosis.
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The Glasgow Coma Scale (GCS)
OBSERVATION
RESPONSE ELICITED
Eye response
Opens spontaneously
4
Opens to verbal command
3
Opens to pain
2
No response
1
Reacts to verbal command
6
Motor response
SCORE
Reacts to painful stimuli
Verbal response
Identifies localized pain
5
Flexes and withdraws
4
Assumes flexor posture
3
Assumes extensor posture
2
No response
1
Is oriented and converses
5
Is disoriented, but converses
4
Uses inappropriate words
3
Makes incomprehensible sounds
2
No response
1
Total scores
15
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REACTION TO PAIN
 In case of cardiac arrest, response to painful
stimuli can be tested
 A pin or sharper object can be used in assessing
reaction to pain
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ABILITY TO MOVE
 If the patient is conscious and if spinal or neck
injury is suspected assess the patient's ability to
move his upper and lower extremities.
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