Chapter 12

1. Chapter 12 Vital Signs Assessment

2. OA 9.24 • Describe how to check a victim’s ABCs when performing a primary survey

3. Primary survey

4. The secondary survey • Only begin the secondary survey once the athlete is deemed stable • Begins with an assessment of vital signs • Musculoskeletal Assessment • DOCUMENT EVERYTHING!

5. Vital Signs

6. The Pulse • Reflects condition of patient’s circulatory system and cardiac function • Pulse is found in the artery • Vessel that carries blood away from the heart to the rest of the body • Absence of a pulse indicates cardiac arrest or death

7. The Pulse • Rate, rhythm and quality are assessed • Rate: normal, abnormal • Rhythm: regular, irregular • Quality: weak, strong

8. The Pulse • Normal pulse for adults is 60-80 beats per minute (bpm) • Athlete’s may be 50-60 bpm

9. The Pulse • Abnormal pulses indicate trauma • Rapid & weak: shock, bleeding, diabetic coma, heat exhaustion • Rapid and strong: heatstroke, fright • Slow and strong: skull fracture, stroke • No pulse: cardiac arrest, death.

10. The Pulse • Higher than average pulse rates = tachycardia • Lower than average pulse rates = bradycardia

11. The Pulse • Can be found in 11 different places on the body • Pulse points

12. The Pulse • Radial • Carotid • Brachial • Femoral • Popliteal • Posterior Tibial • Dorsal pedal

13. The Pulse • Use two fingers to measure pulse rate, rhythm, and quality • NEVER USE THE THUMB – WHY?

14. The Pulse • First beat measured is calculated as zero • 10 sec x 6 • 12 sec x 5 • 15 sec x 4 • 30 sec x 2 • 60 sec

15. OA 9.27 • Identify thefollowing:

16. Vital Signs

17. Respiration • Process of exchanging oxygen for carbon dioxide • Takes place in the lungs • Regulated by the brain and CO2 levels in the bloodstream • Single respiration consists of one inspiration and one expiration

18. Respiration • General guidelines for normal rates are: • 15 years and older: • 12-20 breaths per minute • Well-trained athlete: • 6-8 breaths per minute

19. Respiratory Patterns • Abdominal – belly breathing • Apnea – absence of breathing • Tachypnea – rapid breathing • Bradypnea – slow breathing • Cheyne-Stokes respiration – pattern of rapid deep breathing followed by apnea

20. Respiratory Patterns • Dyspnea – difficulty breathing • Kussmaul’s breathing – hyperventilation • Caused by too much CO2in the blood • Labored breathing – shown by using shoulders, neck, back muscles to breath

21. Measuring Respiration • Respiratory rate & pattern are measured • Count inhalations & exhalations • Watch for chest rise & fall • 30 sec x 2 = breaths per minute • Describe pattern

22. Measuring Respiration • Never tell the patient you aremeasuring their respiration • Why?

24. Lung Volumes • The volume of air associated with the phases of the respiratory • Inhalation • exhalation

25. Lung Volumes • Total Lung Capacity (TLC) – the volume of the lungs at maximal inflation • Tidal Volume (TV) – the volume of air moved in and out of the lungs during normal breathing

26. Lung Volumes • Vital capacity (VC) – the volume of air breathed out after maximal inhalation • Peak Expiratory Flow (PEF) – the highest forced exhalation measured with a peak flow meter

28. Peak Flow Meter • Measures the highest volume of air a person can exhale • Measured in liters per minute (L/min) • Indicates airway function • Used to monitor the effectiveness of medications (inhalers)

29. Peak Flow Meter

30. Using a PFM • A baseline “personal best” is established over a 2-3 day period • Measures are taken and compared to the baseline value

31. Using a PFM • PEF>80% - person clear to workout without limitations • 50%<PEF<80% - person should take medication to raise PEF; workout might need to be altered; person should be monitored closely • PEF<50% - the person should be transported for emergency medical care

32. VITAL SIGNS

33. Blood Pressure • Measurement of pressureof the blood against walls of arteries • Systolic & Diastolic measurements • Systolic– heart contraction • Top number • Diastolic– heart relaxation • Bottom number

34. Blood Pressure • Affected by many factors • Amount of blood in body • Fluid levels (dehydration) • Force of heartbeat • Condition of the arteries

35. Blood Pressure • Affected by many factors • Age, exercise, sex, obesity, food, pain, stress, stimulants, steroids, medications can increase BP • Weight loss, fasting, depression, blood loss can decrease BP

36. Blood Pressure • Hereditary & genetic implications • Exercise increases efficiency of the heart

37. Blood Pressure • Blood pressure is measured in millimeters of Mercury (mm Hg) • Normal blood pressure: • Systolic = 115-120 mm Hg • Diastolic = 75-80 mm Hg

38. Blood Pressure • High blood pressure is hypertension(135/90) • Cardiac problems or stroke • Low blood pressure is hypotension(110/65) • Hemorrhage, shock, heart attack, internal bleeding, dehydration

39. Blood Pressure

40. Blood pressure • Measured with a sphygmomanometer and stethoscope • Process known as auscultation

41. Measuring Blood Pressure • Place cuff around upper arm, just above elbow • Stethoscope head is placed in the antecubital fossa (crook of the elbow

42. Measuring Blood Pressure • Inflate bulb to 180-200 mm Hg • Open the valve to slowly deflate

43. Measuring Blood Pressure • Listen for heart beat • Whooshing noise • First sound heard is systolicvalue • Last sound heard is diastolicvalue

44. Blood Pressure

45. Measuring Blood Pressure http://www.youtube.com/watch?v=S648xZDK7b0

46. Body Temperature • Core temperature • Must remain within a relatively narrow range in order for the body’s various systems to function efficiently

47. Body Temperature • Regulated by an area in the brain known as the hypothalamus • Group of cells monitors the temperature of the blood and responds to any change of temperature • Normal body temperature is 98.6 degrees Fahrenheit