Human Pulse Rates and Conditions

Pulse

• Normal pulse rates for healthy adults range from 60 to 100 BPM; previously ranged 60 to 80 BPM. Risk increases for heart attack at rates over 80 BPM.
• Athletes or individuals who exercise may have pulse rates between 40 and 60 BPM.

Tachycardia

• Defined as a rapid pulse rate exceeding 100 BPM, often signaling the body's attempt to enhance oxygen delivery to cells.
• Common causes include fever, exercise, nervous excitement, medications, and conditions like congestive heart failure (CHF) or shock.
• Nervousness, particularly in a dental setting, frequently leads to increased pulse; relaxation techniques like communication and nitrous oxide sedation can help.

Bradycardia

• A pulse rate of less than 60 BPM, which can lead to lightheadedness, dizziness, chest pain, syncope, or circulatory collapse.
• Treatment involves Atropine to increase heart rate, typically administered by trained dental professionals.
• Patients with chronic bradycardia may require a pacemaker.

Assessment of Rhythm and Strength

• Rhythm refers to the regularity of pulse patterns; irregularities may indicate arrhythmia.
• Pulse strength reflects stroke volume; a bounding pulse in hypertensive patients increases the risk of cerebrovascular accidents (CVA), while a weak (thready) pulse suggests decreased stroke volume.

Referrals for Irregular Pulses

• Patients exhibiting pulse irregularities should be referred to a physician for further evaluation.

Respiration

• Respiration involves the exchange of oxygen (O2) and carbon dioxide (CO2) in the body.
• External respiration is the intake of O2 and elimination of CO2 via the lungs; internal respiration involves O2 utilization and CO2 production at the cellular level.

Respiratory Rates

• Normal adult respiration rate ranges from 12 to 20 RPM; for children, 18 to 22 RPM.
• Tachypnea indicates an abnormally fast respiration rate over 20 RPM, often seen in hyperventilation.
• Bradypnea signifies a slow rate under 12 RPM, commonly associated with syncope.

Apnea

• Defined as a temporary cessation of breathing; prolonged apnea can lead to respiratory arrest, cell death, or brain damage due to insufficient oxygen (hypoxia).

Assessing Respiratory Rhythm and Depth

• Normal breathing rhythm should be regular, with expiration lasting twice as long as inspiration.
• Abnormal breathing patterns include Biot's respiration, Cheyne-Stokes respiration, and Kussmaul breathing.

Quality of Respiration

• Normal breathing should be quiet and effortless; abnormalities like dyspnea indicate labored breathing requiring oxygen.
• Noises associated with respiration include stridor (harsh, crowing sound) linked to obstruction, wheezing (high-pitched sound) often due to asthma, and sighs reflective of stress.

Factors Affecting Respiration

• Age, medications, stress, exercise, altitude, gender, and body position all influence respiratory rates and efficiency.
• As people age, lung elasticity decreases, typically increasing the respiratory rate.

Temperature

• Normal body temperature ranges from 96.4°F to 99.6°F (35.8°C to 37.5°C).

Pyrexia/Fever

• A fever is defined as a temperature above 98.6°F (37°C) and can result from infections, malignancies, CHF, trauma, or drug reactions.
• Extremely high fevers may lead to convulsions or delirium; medical referral is necessary.

Hypothermia

• Diagnosed with a temperature below 95°F (35°C) with signs such as shivering and cool skin.
• Causes include illness, trauma, malnutrition, and certain medications; medical referral is required.

Blood Pressure

• Represents the force exerted against blood vessel walls, typically recorded as systolic over diastolic readings.

Importance of Vital Signs

• Accurate assessment of vital signs is crucial for assessing the body’s ability to pump blood and breathe, determining patient health status.
• Baseline vitals are essential for evaluating changes during medical emergencies.

Pulse Measurement Sites

• Common pulse sites include the carotid (neck), radial (wrist), brachial (arm), and femoral (groin) arteries.
• The radial pulse is the most commonly measured site in dental settings.