Vital Signs Lecture Notes PDF
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Summary
These lecture notes cover vital signs in a dental practice setting, discussing normal ranges, abnormal patterns such as tachycardia and bradypnea, and factors affecting vital signs. The document also includes discussions on pulse types and rates for both adults and children.
Full Transcript
DH 410 – EMERGENCIES IN DENTAL PRACTICE Lecture 4: Vital Signs Introduction Accurate assessment and recording of vital signs is essential Proper use of BP cuff and stethoscope Proper placement on arm (artery placement) Proper size for pat...
DH 410 – EMERGENCIES IN DENTAL PRACTICE Lecture 4: Vital Signs Introduction Accurate assessment and recording of vital signs is essential Proper use of BP cuff and stethoscope Proper placement on arm (artery placement) Proper size for patient arm (pediatric, adult, extra large) Accurate interpretation of BP (sounds) Accurate interpretation of Pulse & Respiration Baseline vital signs are needed for comparison during medical emergency to determine severity Previous charted vitals Vitals charted for current appointment Introduction Vital signs Determine the body’s ability to pump blood and breathe Determine health status of patient Pulse Respiration Blood pressure Temperature Oxygen Saturation Pulse Usual sites Carotid in neck Radial pulse in wrist Brachial pulse in arm (especially children) Femoral pulse in groin Most common site in dental office Radial pulse Figure 3.1 Taking a pulse rate Grimes, E. B. (2014). Medical emergencies: Essentials for the Dental Professional. Prentice Hall. Pulse Normal pulse rates Healthy adult: 60 – 100 BPM Used to be considered 60 – 80 BPM However, those with greater than 80 BPM are in a group at higher risk of heart of attack https://www.health.harvard.edu/heart-health/what-your-heart-rate-is-telling-you Athletes/Individuals who exercise: 40 – 60 BPM Pulse Tachycardia Rapid pulse rate ( > 100 BPM) Body’s attempt to increase O2 to cells Often occurs due to fever, exercise, nervous excitement, medications or stimulant-type drugs, disease states (CHF, hemorrhage, shock) Most often due to nervousness (in dental office) Use relaxation techniques first Communication Nitrous Oxide Sedation Pulse Bradycardia Less than 60 BPM May cause lightheadedness, dizziness, chest pain, syncope, circulatory collapse Treated with Atropine to increase heart rate Not something a hygienist will administer Usually in emergency kits of DDS with training in sedation and general anesthesia (Source: Malamed SF. Medical Emergencies in the Dental Office. 7th Edition) FYI: Many patients with continued or chronic bradycardia require a pacemaker Pulse Assess rhythm and strength Rhythm – relation of one pulse to another as measured by regularity of action Irregular pulse could be a sign of arrhythmia Strength – reflects volume of blood pushing against vessel walls with each contraction (AKA stroke volume) Bounding pulse can be dangerous in hypertensive patients Increased risk of CVA Weak pulse (thready) – decreased stroke volume Difficult to detect pulse Pulse Patients with pulse irregularities should be referred to physician for further assessment Respiration Process by which O2 and CO2 exchanged External respiration O2 taken IN CO2 eliminated via LUNGS Internal respiration Use of O2 Production of CO2 Exchange between CELLS Respiration Respiration Rate Number of breaths/min (BPM) or respiration / min (RPM) Rise and fall of chest Discretely (observed while taking pulse) Adult normal rate: 12 – 20 RPM Children normal rate: 18 – 22 RPM Respiration Rate Tachypnea – abnormally fast rate > 20 Often seen in hyperventilation Bradypnea – slow rate < 12 Often seen in syncope Respiration Rate Apnea – absence of breathing If continues results in respiratory arrest Cannot sustain life Brain requires O2 Hypoxia O2 deprivation of 3 minutes leads to cell death / brain damage 10 minutes or longer leads to coma or death Taking a respiration rate Taking a pulse rate Respiration Rhythm and depth assessment Should be regular Expiration twice as long as inspiration Respiration Abnormal patterns Biot’s Respiration– periods of shallow breathing, alternating with apnea Cheyne-Stokes Respiration – increased rate and depth alternating with apnea Kussmaul Breathing – increased depth and rate > 20 Often seen in hyperventilation, DKA (Diabetic Ketoacidosis), or renal failure Respiration Quality Should be quiet, automatic, effortless Abnormalities usually involve effort or noise Dyspnea – labored breathing, requires excessive effort Usually require oxygenation Respiration Quality Noises Stridor – harsh sound on inspiration – crowing Associated with obstruction Wheezing – high-pitched sound on expiration or inspiration Associated with asthma Sighs – deep inspiration and prolonged expiration Stress Aids in expanding small airways Respiration Factors affecting respiration Age Medications Stress Exercise Altitude Gender (based on genetics not choice) Body Position See next slides for further explanation Respiration Factors affecting respiration Age Lung capacity increases from childhood to adulthood Lower respiratory rate As adult ages lungs less elastic – rate increases Medications Narcotics decrease respiratory rate Depress Sympathomimetics dilate bronchioles, improving respiration Stimulants Respiration Factors affecting respiration Stress Increases strength and depth Exercise Increases strength and depth Altitude Increased altitude – O2 decreases – rate and depth increases Gender Men have larger lung capacity, thus decreased rate Body position Slumped or stooped – more difficult to exchange O2 Increased rate and depth Temperature Measure of heat associated with metabolism of body Normal 96.4°F - 99.6°F https://health.clevelandclinic.org/body-temperature-what-is-and-isnt-normal/ Normal 35.8°C – 37.5°C Taking a temperature Temperature Pyrexia/Fever >98.6°F (37°C) Can occur with: Infection Malignancy (associated with Cancer) CHF (congestive heart failure) Trauma Drugs Possible: Convulsions or delirium may occur with extremely high fevers Refer to MD Temperature Hypothermia >95°F (35°C) Outward signs: Shivering Cool skin Pallor Etiology: Illness Trauma Malnutrition Medications Refer to MD Blood Pressure Force exerted against the blood vessel walls Systolic/diastolic (