2024 Intro to DDS 3 Vitals - PDF

Prague, Czech Republic DSRE 5522 Summer 2024 Course Directors James Delapp, DDS MS Douglas Wilson, DDS MS Rick Mediavilla DDS FAGD Course participants: Lots of other faculty Intro to DDS 3 Summer 2024 Dental School is A. Much harder than I expected B. A little harder than I expected C. About what I...

Prague, Czech Republic DSRE 5522 Summer 2024 Course Directors James Delapp, DDS MS Douglas Wilson, DDS MS Rick Mediavilla DDS FAGD Course participants: Lots of other faculty Intro to DDS 3 Summer 2024 Dental School is A. Much harder than I expected B. A little harder than I expected C. About what I expected D. There are no words.. The Second Year Vital signs include Blood pressure Pulse Respiration Temperature O2 saturation Variation in vital signs Vital signs can vary with Age Weight Stress Infection other Why vital signs at initial visit? Establishes a baseline value Vital signs may reveal sudden changes in your patient’s condition changes Provides a standard of comparison in the event of an “emergency” during treatment* To help identify abnormalities, either diagnosed or undiagnosed Important indicators of the body’s response to physical, environmental and psychological stressors Blood Pressure BP is the pressure exerted on the arterial walls as blood pulsates through them Systolic: pressure exerted on the arteries during contraction phase of the heartbeat Diastolic: resting pressure on the arteries as the heart relaxes between contractions Auscultatory determination of BP is based on vibrations of blood as it passes through the arteries(Korotkoff Sounds) Korotkoff Sounds Normal BP values Normal Adult Value: 180/>110; Refer to ER! American Heart Association Blood pressure guidelines Factors affecting blood pressure Position* Time of Day (lower when sleeping) Blood Loss (lower) Stress/Pain/Anxiety (higher) Medications HTN Essential Hypertension 95% no identifiable cause Genetics/ environmental factors Malignant Hypertension Rapid increase Systolic pressure > 180/120 Organ Damage (Kidney and Eye) Papilledema BP Instruments gold standard Stethoscope (diaphragm or bell-type) BP cuff Mercury gravity manometer Sphygmomanometer BP Cuff placement Vital signs after allowing for pt. to sit for ~5 min. Patient seated with arm at level of heart Cuff securely placed around patient’s upper arm 1 inch above antecubital fossa Orientation of the cuff is aided by arrows that indicate the brachial artery Bell is placed lightly over the brachial artery Omron BP Wrist Cuff Estimating Systolic Pressure Estimating systolic (how high to inflate?) Place fingers over radial artery, inflate cuff until radial pulse disappears Inflate cuff to 20 - 30 mm Hg ABOVE this number* Korotkoff Sounds and BP False Reading False “Lows”: Arm above heart, Cuff too wide (big) Stethoscope bell applied too firmly False “Highs”: Cuff too narrow (small), overinflated Arm too much below patient’s heart, Pt’s own effort to hold arm (not relaxed), Clothing Recent physical exertion Cigarettes or coffee Stress Anxiety or PAIN When do you take BP? Initial visit (baseline) Recall visits (AND change in condition) Every visit for hypertensive patients Pre, peri and post-operatively Surgical procedures for ALL patients Significant change in medical condition Pulse The rhythmical dilation of arteries produced when blood is pumped outward by regular contractions of the heart Assess Rate Rhythm (regular or irregular) Strength (weak or full volume) Pulse Values Normal Adult Value: 60-100 beats per minute >100 bpm = TACHYCARDIA