Transcript Pulse - El Camino College

Vital Signs
RTEC 93
Venipuncture for Radiographers
When do you wash your hands?
When hands are visibly soiled
 Before and after patient contact
 After removal of gloves
 After using the toilet
 After blowing or wiping the nose
 Upon leaving an isolation area
 How long do you wash?

Equipment Needed
A Stethoscope
 A Blood Pressure Cuff
(Sphygmomanometer)
 A Watch Displaying Seconds

Vital Signs
 Indication of
 Physical assessment
Homeostasis
 Primary Mechanisms
include measurement
of vital signs
 Body Temperature
Pulse
Respiration
Blood Pressure
Mental Status
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Heart beat
Blood pressure
Body temperature
Respiratory rate
Electrolyte
balance
General Considerations for taking
vital signs
Ideally the patient should be sitting with
feet on the floor and their back supported.
The examination room should be quiet and
the patient comfortable.
 History of hypertension, slow or rapid
pulse, and current medications should
always be obtained.

Body Temperature
CAUTION: Do not mix oral and rectal thermometers.
 Normal average body
 Measuring Body
temperature: 98.6 F
Humans can survive
between 106 F and
93.2 F.
Temperature
 Hypothermia
 Axillary
 Hyperthermia
 Tympanic
 Oral
 Rectal
 Temporal
Artery (TA)
Thermometers
Pulse
 Pulse rate: Adult = 60 to 100 beats per
minute
 Children under 10 = 70 to 120 beats per
minute
 Tachycardia
 Bradycardia
Common Sites Used for Taking a
Patient's Pulse
 1. Radial artery--inside the wrist near the
base of the thumb
 2. Brachial artery--located in the depression
proximately ½ inch from the crease on the
inside of the elbow
 3. Carotid artery--located in the groove on
either side of the windpipe
 4. Apical--at the apex of the heart
(stethoscope needed)
Pulse
 Wash Hands
 Identify your patient
 Introduce your self and explain the procedure
 Position the patient lying down or seated, with
palm up, arm comfortable and supported
 Sit or stand facing your patient.
Pulse
 Grasp the patient's wrist with your free (non-
watch bearing) hand (patient's right with your
right or patient's left with your left). There is
no reason for the patient's arm to be in an
awkward position, just imagine you're shaking
hands.
 Compress the radial artery with your index
and middle fingers. Is using your thumb a
good idea?
Radial, Brachial or Carotid Artery
Pulse
 Note whether the pulse is regular or irregular:
 Regular - evenly spaced beats, may vary
slightly with respiration
 Regularly Irregular - regular pattern overall
with "skipped" beats
 Irregularly Irregular - chaotic, no real
pattern, very difficult to measure rate
accurately
Pulse
 Count the pulse for 15 seconds and multiply
by 4.
 Count for a full minute if the pulse is irregular.
 Record the rate and rhythm.
Respiratory Rate
 Breaths per minute: Adult = 12 to 20
 Children under 10 = 20 to 30 per min
 Tachypnea
 Bradypena
 Dyspnea
 Apnea
Respiratory Rate
 Best done immediately after taking the
patient's pulse. Do not announce that you are
measuring respirations.
 Have patient remove bulky clothing
(if
possible) that might interfere with observation
of chest movement.
 Position patient sitting or supine.
Respiratory Rate
 Place your fingers on patient's wrist as if you
are taking his pulse. Also, if there is difficulty
in seeing chest movement, you may fold the
patient's arm diagonally across their chest,
allowing you to feel the movement instead.
 Without letting go of the patients wrist begin
to observe the patient's breathing. Is it normal
or labored?
Respiratory Rate
 Inspiration + Expiration = 1
 Count breaths for 15 seconds and multiply
this number by 4 or 30 seconds and multiply
by 2 or for 1 minute to yield the breaths per
minute.
Pulse Oximeter
• Normal Pulse
Oximeter = 95%
to 100%
Oxygen
 Oxygen constitutes 21% of atmospheric
gases
 If O2 levels in the body drop below 21%
homeostasis is altered.
 Hypoxia: Inadequate amount of oxygen at
the cellular level.
Blood Pressure
• Blood Pressure
• Systolic pressure =
95-140 mmHg
• Diastolic pressure =
60-90 mmHg
• Hypertension
• Hypotension
Blood Pressure
 Wash Hands
 Identify your patient
 Introduce your self and explain the procedure
 Position the patient lying down or seated,
comfortable
 Position the patient's arm so the anticubital
fold is level with the heart. Support the
patient's arm with your arm or a bedside
table. Position the patient's arm so it is
slightly flexed at the elbow.
Blood Pressure
 Locate brachial pulse by palpation
 Place cuff 1 to 2 inches above elbow or
anticubital fold.
 Proper cuff size is essential to obtain an
accurate reading.
 Position arrow on the cuff over brachial
artery
 CAUTION: The inflated cuff is not to stay
in place any longer than 2 minutes
Blood Pressure
 Position gauge where you will have full view
to observe the column or dial
 Place ear piece of stethoscope facing forward
in ears. This is the only correct placement
any time a stethoscope is used
 Do not use thumb to stabilize diaphragm on
arm, as your pulse may be heard instead of
the patient's blood pressure
Blood Pressure
 Palpate the radial pulse and inflate the cuff
until the pulse disappears. This is a rough
estimate of the systolic pressure
 Place the stethoscope over the brachial
artery.
 Inflate the cuff to 30 mmHg above the
estimated systolic pressure.
 Release the pressure slowly, no greater than
5 mmHg per second.
Blood Pressure
 The level at which you consistently hear
beats is the systolic pressure
 Continue to lower the pressure until the
sounds muffle and disappear. This is the
diastolic pressure
 Release remaining air
 Record the blood pressure as systolic over
diastolic ("120/70" for example).
Central Line Injections by RT
• Does California Law
address arterial
injection by RT’s ?
• What are the
important parts of the
law to know?
Central Line Injections by RT
• The California Law
does not address
arterial injection by
RT
• Employers policies
• Saline flush
Review
 Vital Signs
 Respiration
 Homeostasis
 Blood Pressure
 Body
 Mental Status
Temperature
 Pulse
 Pulse Oximeter
Questions?
• Vital Signs
• Demo and
practice in lab