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==Additional signs== ==Additional signs==
===Fifth sign=== ===Fifth sign===
The phrase "fifth vital sign" usually refers to ], as perceived by the patient on a ] of 0-10. For example, the ] made this their policy in 1999. However, some doctors have noted that pain is actually a subjective ], not an objective ], and therefore object to this classification.<ref>http://www.asahq.org/Newsletters/2004/11_04/lte11_04.html</ref> The phrase "fifth vital sign" usually refers to ], as perceived by the patient on a ] of 0-10. For example, the ] made this their policy in 1999. However, some doctors have noted that pain is actually a subjective ], not an objective ], and therefore object to this classification.<ref>Harold S. Lee. November 2004. , in Letters to the Editor. ''American Society of Anesthesiologists'', Volume 68, Number 11. </ref>


Other sources include ] as their fifth sign.<ref>{{cite journal |author=Mower W, Myers G, Nicklin E, Kearin K, Baraff L, Sachs C |title=Pulse oximetry as a fifth vital sign in emergency geriatric assessment |journal=Acad Emerg Med |volume=5 |issue=9 |pages=858-65 |year=1998 |id=PMID 9754497}}</ref><ref>{{cite journal |author=Mower W, Sachs C, Nicklin E, Baraff L |title=Pulse oximetry as a fifth pediatric vital sign |journal=Pediatrics |volume=99 |issue=5 |pages=681-6 |year=1997 |id=PMID 9113944}}</ref><ref>{{cite journal |author=Neff T |title=Routine oximetry. A fifth vital sign? |journal=Chest |volume=94 |issue=2 |pages=227 |year=1988 |id=PMID 3396392}}</ref> Other sources include ] as their fifth sign.<ref>{{cite journal |author=Mower W, Myers G, Nicklin E, Kearin K, Baraff L, Sachs C |title=Pulse oximetry as a fifth vital sign in emergency geriatric assessment |journal=Acad Emerg Med |volume=5 |issue=9 |pages=858-65 |year=1998 |id=PMID 9754497}}</ref><ref>{{cite journal |author=Mower W, Sachs C, Nicklin E, Baraff L |title=Pulse oximetry as a fifth pediatric vital sign |journal=Pediatrics |volume=99 |issue=5 |pages=681-6 |year=1997 |id=PMID 9113944}}</ref><ref>{{cite journal |author=Neff T |title=Routine oximetry. A fifth vital sign? |journal=Chest |volume=94 |issue=2 |pages=227 |year=1988 |id=PMID 3396392}}</ref>

Some sources consider ] size, equality, and reactivity to light to be a vital sign as well.<ref name="brady">Daniel Limmer and Michael F. O'Keefe. 2005. ''Emergency Care'' 10th ed. Edward T. Dickinson, Ed. Pearson, Prentice Hall. Upper Saddle River, New Jersey. Page 212 and 218.</ref>


===Sixth sign=== ===Sixth sign===
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*]<ref>{{cite journal |author=Joseph A |title=Continence: the sixth vital sign? |journal=Am J Nurs |volume=103 |issue=7 |pages=11 |year=2003 |id=PMID 12865635}}</ref> *]<ref>{{cite journal |author=Joseph A |title=Continence: the sixth vital sign? |journal=Am J Nurs |volume=103 |issue=7 |pages=11 |year=2003 |id=PMID 12865635}}</ref>
* End-tidal ]<ref>{{cite journal |author=Vardi A, Levin I, Paret G, Barzilay Z |title=The sixth vital sign: end-tidal CO2 in pediatric trauma patients during transport |journal=Harefuah |volume=139 |issue=3-4 |pages=85-7, 168 |year=2000 |id=PMID 10979461}}</ref> * End-tidal ]<ref>{{cite journal |author=Vardi A, Levin I, Paret G, Barzilay Z |title=The sixth vital sign: end-tidal CO2 in pediatric trauma patients during transport |journal=Harefuah |volume=139 |issue=3-4 |pages=85-7, 168 |year=2000 |id=PMID 10979461}}</ref>
*Emotional ] <ref>{{cite journal |author=Bultz B, Carlson L |title=Emotional distress: the sixth vital sign--future directions in cancer care |journal=Psychooncology |volume=15 |issue=2 |pages=93-5 |year=2006 |id=PMID 16444764}} </ref> *Emotional ]<ref>{{cite journal |author=Bultz B, Carlson L |title=Emotional distress: the sixth vital sign--future directions in cancer care |journal=Psychooncology |volume=15 |issue=2 |pages=93-5 |year=2006 |id=PMID 16444764}} </ref>
* ] <ref>http://www.ohsu.edu/medicine/residency/handouts/0405handouts/COPD091304.ppt </ref> * ]<ref>http://www.ohsu.edu/medicine/residency/handouts/0405handouts/COPD091304.ppt </ref>
*]<ref>http://www.medicine.uiowa.edu/cme/about/documents/PrintHandout.ppt </ref> *]<ref>http://www.medicine.uiowa.edu/cme/about/documents/PrintHandout.ppt </ref>
* Functional Status <ref>{{cite journal |author=Bierman A |title=Functional status: the sixth vital sign |journal=J Gen Intern Med |volume=16 |issue=11 |pages=785-6 |year=2001 |id=PMID 11722694}} </ref> * Functional Status<ref>{{cite journal |author=Bierman A |title=Functional status: the sixth vital sign |journal=J Gen Intern Med |volume=16 |issue=11 |pages=785-6 |year=2001 |id=PMID 11722694}} </ref>
*] level *] level

==Variations by age==
{| align="right" border="1" cellpadding="2" style="text-align:center"
!width="125"|Age
!width="125"|Normal heart rate (beats per minute)<ref>''Emergency Care'', Page 214</ref>
!width="125"|Normal respiratory rate (breaths per minute)<ref>''Emergency Care'', Page 215</ref>
|-
|newborn || 120-160 || 30-50
|-
|0-5 months || 90-140 || 25-40
|-
|6-12 months || 80-140 || 20-30
|-
|1-3 years || 80-130 || 20-30
|-
|3-5 years || 80-120 || 20-30
|-
|6-10 years || 70-110 || 15-30
|-
|11-14 years || 60-105 || 12-20
|-
|14+ years || 60-100 || 12-20
|}
Children and infants have respiratory and heart rates that are faster than those of adults. At right is a table showing normal heart and respiratory rates for people of different ages.


==See also== ==See also==

Revision as of 21:19, 1 May 2007

This article is about vital signs in medicine. For other uses of the term, see Vital signs (disambiguation).

Vital signs are often taken by health professionals in order to assess the most basic body functions. Vital signs are an essential part of a case presentation.

Primary four

There are four vital signs which are standard in most medical settings:

  1. Temperature examination for normal temperature.
  2. Pulse rate (or heart rate).
  3. Blood pressure.
  4. Respiratory rate.

The equipment needed is a thermometer, a sphygmomanometer, and a watch.

Though a pulse can often be taken by hand, a stethoscope may be required for a patient with a very weak pulse.

Additional signs

Fifth sign

The phrase "fifth vital sign" usually refers to pain, as perceived by the patient on a Pain scale of 0-10. For example, the Veterans Administration made this their policy in 1999. However, some doctors have noted that pain is actually a subjective symptom, not an objective sign, and therefore object to this classification.

Other sources include pulse oximetry as their fifth sign.

Some sources consider pupil size, equality, and reactivity to light to be a vital sign as well.

Sixth sign

There is no standard "sixth vital sign", and the use is much more informal and discipline-dependent than with the above, but some proposals (excluding the fifth sign candidates above) include:

Variations by age

Age Normal heart rate (beats per minute) Normal respiratory rate (breaths per minute)
newborn 120-160 30-50
0-5 months 90-140 25-40
6-12 months 80-140 20-30
1-3 years 80-130 20-30
3-5 years 80-120 20-30
6-10 years 70-110 15-30
11-14 years 60-105 12-20
14+ years 60-100 12-20

Children and infants have respiratory and heart rates that are faster than those of adults. At right is a table showing normal heart and respiratory rates for people of different ages.

See also

References

  1. Harold S. Lee. November 2004. Physical Diagnosis 101: A Lesson From the First Year of Medical School, in Letters to the Editor. American Society of Anesthesiologists, Volume 68, Number 11.
  2. Mower W, Myers G, Nicklin E, Kearin K, Baraff L, Sachs C (1998). "Pulse oximetry as a fifth vital sign in emergency geriatric assessment". Acad Emerg Med. 5 (9): 858–65. PMID 9754497.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  3. Mower W, Sachs C, Nicklin E, Baraff L (1997). "Pulse oximetry as a fifth pediatric vital sign". Pediatrics. 99 (5): 681–6. PMID 9113944.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  4. Neff T (1988). "Routine oximetry. A fifth vital sign?". Chest. 94 (2): 227. PMID 3396392.
  5. Daniel Limmer and Michael F. O'Keefe. 2005. Emergency Care 10th ed. Edward T. Dickinson, Ed. Pearson, Prentice Hall. Upper Saddle River, New Jersey. Page 212 and 218.
  6. Joseph A (2003). "Continence: the sixth vital sign?". Am J Nurs. 103 (7): 11. PMID 12865635.
  7. Vardi A, Levin I, Paret G, Barzilay Z (2000). "The sixth vital sign: end-tidal CO2 in pediatric trauma patients during transport". Harefuah. 139 (3–4): 85–7, 168. PMID 10979461.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  8. Bultz B, Carlson L (2006). "Emotional distress: the sixth vital sign--future directions in cancer care". Psychooncology. 15 (2): 93–5. PMID 16444764. link
  9. http://www.ohsu.edu/medicine/residency/handouts/0405handouts/COPD091304.ppt
  10. http://www.medicine.uiowa.edu/cme/about/documents/PrintHandout.ppt
  11. Bierman A (2001). "Functional status: the sixth vital sign". J Gen Intern Med. 16 (11): 785–6. PMID 11722694. link
  12. Emergency Care, Page 214
  13. Emergency Care, Page 215

External links

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