L-2 Vital signs I (temp, puls)_79476e73cfdeb8855a56b0bd61def6fb.pptx

L 2 - Anesthesia Technology Fundamentals II AT-ATF II 202 Vital Signs Nithin Raj MSc AT February 11, 2025 Anesthesia Technology – Nithin www.gmu.ac.ae...

L 2 - Anesthesia Technology Fundamentals II AT-ATF II 202 Vital Signs Nithin Raj MSc AT February 11, 2025 Anesthesia Technology – Nithin www.gmu.ac.ae CoHS COLLEGE OF ALLIED HEALTH Learning objectives Describe factors that affect the vital signs and accurate measurement of them. Identify the normal range for each vital sign. Identify the variations in normal body temperature, pulse, Identify nine sites used to assess the pulse. List the characteristics that should be include when assessing pulses Describe the mechanics of breathing and the mechanisms that control respirations. Identify the components of respiratory assessment Introduction Assessing vital signs or cardinal sign is a routine medical procedure and somehow determines the internal functions of the body Vital signs composes of Body temperature Pulse the following: Respiration and Blood pressure Vital sign physical signs that provide data to determine a person’s state of health indicate an individual is alive, such as temperature, pulse rate, respiratory rate (TPR), and blood pressure (BP). Body temperature  It is the balance between the heat gain and the heat lost from the body.  It is measured in heat units, called degrees.(Celsius or Fahrenheit)  Normal body Temperature range: (36.5 – 37.5 °C) CORE Temperature- is the temperature of the deep tissues of the body, such as the cranium, thorax, abdominal cavity and pelvic cavity.  A part of the brain known as the hypothalamus is responsible for maintaining homeostasis , a constant internal environment, in the body. Measuring Body Temperature Purposes 1. To establish baseline data for subsequent evaluation. 2. To identify whether the core body temperature is within normal range. 3. To determine changes in the core body temperature in response to specific therapies ( antipyretic medication , immunosuppressive drugs, invasive procedure ) 4. To monitor clients at risk for imbalanced body temperature( clients at risk for infection , or diagnosis of infection , Types of Thermometer 1. Mercury in glass a. Oral thermometer have a long, slender tips b. Rectal thermometer have a short, rounded tips 2. Electronic thermometer  Digital thermometer 3. Infrared thermometer  Tympanic thermometer Temperature sensitive strip Rectal Thermometer Oral thermometer Digital thermometer Temperature strip Infra red thermometer Types of Thermometers 1. Glass and mercury thermometers a glass tube with mercury inside of the tube. The tube goes underneath the tongue and the body temperature will cause the mercury to rise inside the tube.  Types of Thermometers 2. Electronic thermometers Provide readings in less than 60 seconds most accurate if placed in sublingual pocket There is a sensor on the end of the thermometer that touches the body part and reads the body’s temperature. Types of Thermometer 3. Tympanic membrane thermometer measures the temperature inside of the ear. It will read the infrared heat that comes from inside of the ear. Especially appropriate for infants and young children Readings are obtained in 2 seconds or less Body Temperature measurement Temperature sites: Oral, rectal, axillary, tympanic membrane, temporal artery, esophageal, pulmonary artery Oral- most common Axilla –mostly used in infants and children Rectal- second choice Tympanic membrane- most favorable site Temporal – specially for pediatric group Sites commonly used in taking Body Temperature  Sites for taking the Temperature  Pulmonary catheter Esophageal catheter Temperature variation 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. Sites for taking the Temperature SITE ADVANTAGES DISADVANTAGES Thermometers can be broken Inaccurate if client has just ingested hot or cold fluid, or smoked ORAL Accessible and convenient Inconvenient and more unpleasant; difficult for client who cannot turn to side Could injure the rectum following surgery RECTAL Reliable measurement Presence of stool may interfere with thermometer placement Thermometer must be left in place for a long time AXILLARY Safe and noninvasive Can be uncomfortable and involves risk of injuring the membrane if inserted too far TYMPANIC Readily accessible; reflects the core temperature, MEMBRANES very fast Presence of cerumen can affect the reading Requires electronic equipment (expensive / unavailable) ; TEMPORAL ARTERY Safe and noninvasive , very fast Variation in technique Factors affecting Body temperature Age – infants greatly influenced by the temperature, children more labile than adult and elderly are extremely sensitive to environmental change due to decreased thermoregulatory control. Diurnal variations (circadian rhythms) – Body temperature normally change throughout the day, varying as much as 1.0 °C between early morning and late afternoon. The point of highest body temperature is usually reached between 8pm and 12 midnight and the lowest point is reached during sleep between 4 a.m. and 6 a.m. 3. Exercise- changes in temperature. 4. Hormones –women usually experience more hormone fluctuations than men, progesterone secretion in women raises body temperature. 5. Stress- epinephrine and nor epinephrine increases metabolic activity and heat production. 6. Environment 7. Ingestion of hot/cold liquids 8. Smoking Alteration in Body temperature Pyrexia or fever- increase body temperature that exceeds febrile means with fever normally from the daily Afebrile means without fever variation. Hypothermia - decrease in core temperature below the low limit of normal body temperature. Hyperthermia – elevated body temperature due to failed thermoregulation that occurs when a body produces or absorbs more heat than it dissipates.  PULSE is a wave of blood generated by contraction of the left ventricle of the heart in the whole body at same time. Generally, the pulse wave represents the stroke volume output and the amount of blood that enters the arteries with each ventricular contraction. Cardiac output is the volume of blood pumped into the arteries by the heart and equals the result of the stroke volume (SV) times the heart rate (HR) per minute. SV: The amount of blood ejected with each cardiac contraction  Pulse Rate Definition: It is the rate of heart beats per minute. Pulse is called heart rate, which is the number of time heart beats per minute. Pulse The pulse is a wave-like sensation that can be palpated in a peripheral artery. It is stretched by the wave of blood that is pumped through with each heartbeat. It is produced by the movement of blood during the heart's contraction. Normally, an adult's heart contracts 60 to 100 times a minute. In children and new-born babies, this can be much faster. Areas of pulse Peripheral pulse: is a pulse located in the periphery of the body. Apical pulse: is a central pulse located at the apex of the heart. Peripheral pulse Sites : Factors affecting pulse rate 1. Age 2. Sex- after puberty, the man’s pulse rate is slightly lower than the female 3. Exercise 4. Fever- pulse rate increases when metabolic rate increases 5. Medications 6. Hemorrhage- loss of blood increase pulse rate 7. Stress 8. Position changes 9. Heart disease Some medications decrease the pulse rate, and others increase it. For example, cardiotonics (digitalis) decrease the heart rate, whereas epinephrine increase it. Hypovolemia. Loss of blood from the vascular system normally increases pulse rate. Stress. In response to stress, sympathetic nervous stimulation increases the overall activity of the heart. Stress increases the rate as well as the force of the heartbeat  Hypovolemia. Loss of blood from the vascular system normally increases pulse rate. Stress. In response to stress, sympathetic nervous stimulation increases the overall activity of the heart. Stress increases the rate as well as the force of the heartbeat. 34  Position changes. When a person is sitting or standing, blood usually pools in dependent vessels of the venous system. Pooling results in a transient decrease in the venous blood return to the heart and subsequent reduction in blood pressure and increase in heart rate. Pathology. Certain diseases such as some heart conditions or those that impair oxygenation can alter the resting pulse rate. 35  Tachycardia. heart rate over 100 BPM in adult is referred to as tachycardia. Bradycardia. A heart rate in an adult of 60 BPM or less is called. 36 Characteristics of pulse  Pulse rate  Pulse rhythm  pulse volume  synqurenicity  The pulse rhythm: Is the pattern of the beats and the intervals between the beats. Equal time between beats of a normal pulse. A pulse with an irregular rhythm is referred to as a dysrhythmia or arrhythmia. 38  Pulse volume Also called the pulse strength or amplitude, refers to the force of blood with each beat. Pulse Oximetry Noninvasive Estimates arterial blood oxygen saturation (SpO2) Normal SpO2 85-100%; < 70% life threatening Detects hypoxemia before clinical signs and symptoms Sensor, photodetector, pulse oximeter unit Pulse Oximetry Factors that affect accuracy include: Hemoglobin level Circulation Activity Carbon monoxide poisoning THANKS REFERENCE S References Morgan and Mikhail's clinical anesthesiology 6th edition 2018, ISBN: 978-1-25-983443-1 The anesthesia technologist's manual Emily Guimaraes, Matthew Davis, Glenn Woodworth, Jeffrey R. Kirsch Second edition. | Philadelphia: Wolters Kluwer,