ekg cardiovascular
Vital Signs Interpretation
This is a knowledge skill: know roughly what is expected for each vital sign, recognize out-of-range readings, and pass the right ones on with context.
12 steps2 criticalLimit 4 minAlways tested
Steps
- 1Know the typical adult resting ranges: pulse 60 to 100, respirations 12 to 20, oral temperature roughly 96 to 99 F, and an oxygen saturation target of 94 to 98 percent
- 2Critical stepClassify blood pressure by AHA category: normal is under 120 and under 80; elevated is 120 to 129 and under 80; stage 1 is 130 to 139 or 80 to 89; stage 2 is 140 or higher or 90 or higher
- 3Recognize severe hypertension (higher than 180 and/or higher than 120); with chest pain, shortness of breath, back pain, numbness, weakness, vision change or trouble speaking it is an emergency
- 4Recognize low blood pressure (below 90/60) and an orthostatic drop (at least 20 systolic or 10 diastolic within 3 minutes of standing)
- 5Recognize an abnormal resting pulse: under 60 is slow (bradycardia) and over 100 is fast (tachycardia)
- 6Recognize abnormal respirations: an adult rate under 12 or over 20, or new signs of respiratory distress
- 7Recognize a fever (above 100.4 F or 38 C), a temperature below 95 F (35 C), and an oxygen saturation below the patient's target (often lower with chronic lung disease)
- 8Consider what changes vital signs: activity, medications, recent intake, age, caffeine or nicotine in the last 30 minutes, and measurement technique
- 9Critical stepRecheck an unexpected reading (manually for an unexpected automatic BP; at least 1 minute later for a very high BP) without delaying a report if the patient has symptoms
- 10Report out-of-range readings or symptoms right away per facility policy; do not wait for the next visit
- 11Document the value with the time, position or route, whether on room air or oxygen, and any symptoms
- 12Compare with the patient's baseline and earlier readings; the provider, not the CCMA, diagnoses hypertension or other conditions
What graders are watching for
Tips
- Compare every reading with the patient's baseline and trend; one reading does not make a diagnosis
- Cut-offs differ between sources (for example the WTCS adult BP table and the AHA categories); learn the set your course and office use
- Activity, medications, recent intake and age affect vital signs; note them when you report
Common mistakes
- Memorizing one threshold list when sources and clinics differ, then misapplying it.
- Reporting a number without symptoms, time and context.
- Delaying the report of a symptomatic patient or a severely abnormal value in order to recheck first.
- Calling a patient hypertensive from one reading; the provider makes the diagnosis.
Practice this skill
Practise the sequence with critical-step highlighting and a rationale for each step.
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Sources and how we check them: How we verify.