Vital Signs

1. Vital Signs Introduction and Pulse Foundation Information

2. Homeostasis A state of equilibrium (balance) within the body maintained through the adaptation of body systems to changes in either the internal or external environment. To better understand homeostasis watch the 2 videos on the class website

3. Now, Put the Homeostasis Definition into your own words

4. What happens when Homeostasis is unbalanced • Can lead to shock • Life-threatening medical condition as a result of insufficient blood flow throughout the body • Often accompanies severe injury or illness • Can lead to • Hypoxia- lack of oxygen in tissues • Heart attack • Organ damage • Death • Requires immediate treatment as symptoms can become worse quickly

5. Shock • Signs and symptoms of shock • Rapid weak pulse • Pale, blue/grey, cold/clammy skin • Nausea and thirst • Rapid shallow breathing • Uncounsciousness

6. Shock • Treatment of shock • Treat cause of shock first • Raise and support legs • Keep injured person warm • Call EMS • Calm and reassure injured person • Monitor constantly

7. What are vital signs Vital signs are objective measurements that provide data to determine a persons state of health

8. The four vital Signs Pulse Respiration Blood Pressure Temperature In addition, height and weight are also taken as they can provide insight on the health of an individual.

9. Pulse • Number of times the heart contracts per minute. Pulse is measured in beats per minute and is abbreviated bpm. The medical abbreviation for pulse is P. • Fitness Professionals are concerned with • Resting HR • Exercise HR • Recovery HR

10. Pulse Range • Normal pulse rate varies depending on age. • For the healthy adult the normal resting pulse ranges from 60 to 100 beats per minute • Average is 70 to 80 bpm

11. Pulse Range Tachycardia is characterized as a fast heart rate which is more than 100 beats per minute. This may indicate a patient has some sort of heart disease or the person just finished with vigorous exercise.

12. Pulse Range Bradycardia is characterized as an abnormally low heart rate which is fewer than 60 beats per minute. This may occur during sleep or with trained athletes.

13. Measuring Pulse Pulse is measured by applying moderate pressure on arteries with the sensitive pads located on the tips of the index and middle fingers

14. Measuring Pulse • Arteries: Carry blood away from the heart to the rest of the body. The blood is typically oxygenated*. • Veins: Carry blood back to the heart. The blood is typically deoxygenated*. • *What body system will cause the veins and arteries to flip their oxygen content? Write down an answer, you’ll get the correct answer during the class discussion. It’s okay if you’re incorrect, at least you tried!

15. Arteries and Veins • If you took all the blood vessels out of an average child and laid them out in a line, the line would stretch over 60,000 miles. • An adults would be closer to 100,000 miles

16. Measuring Pulse Manual Palpation Telemetry (Heart Rate Monitor) Electrocardiogram

17. Manual Palpation • 3 Common Sites • Radial • Brachial • Carotid

18. Radial Pulse Lightly press the index and middle fingers against the radial artery in the grove on the anterior surface of the lateral wrist closest to the thumb

19. Brachial Pulse Located in a groove between the biceps and triceps muscles on the medial side of the arm. This location is also used for the auscultation of blood pressure

20. What does auscultation mean? The action of listening to sounds from the heart, lungs, or other organs, typically with a stethoscope, as a part of medical diagnosis.

21. Carotid Pulse Press fingers lightly along the medial border of the sternocleidomastoid muscle in the lower neck region. Should only be used in unable to palpate pulse in the other sites.

22. Manual Palpation Brachial Carotid Radial

23. Carotid Pulse- Last place to take heart rate May lead to an underestimation of true heart rate because baroreceptors on the carotid sinus region become stimulated when touched. May reflexively reduce the client’s heart rate as the baroreceptors sense a false increase in blood pressure. This is known as the baroreceptor reflex.

24. What is a Baroreceptor Sensors located in the blood vessels. Sense blood pressure and relay the information to the brain so that a proper blood pressure can be maintained. Baroreceptors are located in the carotid sinus. For a better understanding watch the video on the class webpage

25. How To Do A Pulse Check Locate anatomic site Gently press down with 2 fingers over the palpation site Count the number of pulsations for a specific time period Begin counting the first pulsation as 1

26. How To Do A Pulse Check Determine heart rate based upon the number of pulsations in a given time period. Accuracy of heart rate increases with longer palpation times 10 seconds = multiply number of pulsations by 6 15 seconds = multiply number of pulsations by 4 30 seconds = multiply number of pulsations by 2

27. Determine Pulse Rates Correct answers will be provided at the end of the slideshow. Remember to include BPM 22 pulses in a 15 second count 66 pulses in a 30 second count 18 pulses in a 10 second count

28. Determine Pulse Rates Correct answers will be provided at the end of the slideshow. Remember to include BPM 43 pulses in a 15 second count 67 pulses in a 30 second count 26 pulses in a 10 second count

29. Additional Locations for Pulse Checks Temporal Artery Femoral Artery Popliteal Artery Dorsal Pedis

30. Heart Rate During Exercise Clients and athletes may wish to monitor their heart rate during exercise. In order to effectively utilize heart rate as a measure of intensity the pulse check must be taken immediately after vigorous (intense) exercise. It is important to continue moving while taking the pulse to prevent blood from pooling in the extremities and causing light-headedness.

31. Blood Pooling Occurs when the walls or valves in the leg veins do not work effectively and make it difficult for the blood to return to the heart. Occurs after exercise because the muscles help push blood back to the heart when they contract. Following exercise the muscles stop putting pressure on the veins and causes blood to pool in the lower body. Can lead to hypotension, dizziness and possibly passing out.

32. Blood Pooling Level 1 Normal Level 2 Level 3 Also occurs in people with heart disease and poor circulation.

33. Measuring Heart Rate During Exercise When measuring exercise heart rate take the pulse for either 15 seconds and multiply by 4 or 30 seconds and multiply by 2 to convert it to a 1 minute value (bpm). The 30 second count may be more accurate, but typically the 15 second count is used because heart rate may decrease rapidly.

34. Telemetry aka Heart Rate Monitor When clients experience difficulty in palpating the pulse the use of a heart rate monitor (also known as telemetry) as a learning tool to check the accuracy of the palpated heart rate. With telemetry the participant wears an electronic heart rate monitor strapped to his or her chest. Heart rate is then transferred to a watch.

35. Telemetry aka Heart Rate Monitor Benefits Gives relatively accurate results No need to stop activity to determine heart rate Client is able to see where the heart rate is at any time which can provide extra motivation.

36. Electrocardiograms Electrocardiograms can also be used to monitor heart rates. Electrodes are placed on the skin of the chest which measures the electrical activity of the heart. Although, they are more likely to be used in a cardiac rehabilitation setting versus a personal training setting.

37. Medications Beta-blockers are medications prescribed for hypertension which significantly decreases resting heart rate and may affect exercise response to heart rate.

38. Chart Noting- Practice • Correct answers will be given at the end of the slideshow • Resting Pulse: 78 beats per minute • Exercise Pulse: 168 beats per minute while performing 1.5 mile run test. Pulse taken at 1 mile mark. • Recovery Pulse:136 beats per minute, 1 minute after Queens College Step Test

39. Fantastic Facts about the Body – Scroll through to the answer Key Your heart beats about 35 million times in a year. During an average lifetime, the human heart will beat more than 2.5 billion times.

40. Fantastic Facts about the Body – Scroll through to the answer Key The average healthy mouth produces about 600 milliliters of saliva each day. That's enough to fill a 12-ounce soda bottle.

41. Fantastic Facts about the Body – Scroll through to the answer Key  Approximately 80-90% of what we perceive as "taste" actually is due to our sense of smell.

42. Fantastic Facts about the Body – Scroll through to the answer Key Red blood cells may live for about four months circulating throughout the body, feeding the 60 trillion other body cells. Red blood cells make approximately 250,000 round trips of the body before returning to the bone marrow, where they were born, to die.

43. Determine Pulse Rates Answers to question 23 • 22 pulses in a 15 second count • 22 X 4 = 88 BPM • 66 pulses in a 30 second count • 66 X 2 = 132 BPM • 18 pulses in a 10 second count • 18 X 6 = 108 BPM

44. Determine Pulse Rates Answers to question 23 • 43 pulses in a 15 second count • 43 X 4 = 172 BPM • 67 pulses in a 30 second count • 67 X 2 = 134 BPM • 26 pulses in a 10 second count • 26 X 6 = 156 BPM

45. Chart Noting- Practice example to question 32 • Resting Pulse: • Date, Time Resting P was measured at 78 bpm and is WNL. Signature with title • Exercise Pulse • Date, Time While performing the 1.5 mile run test, P was recorded at the 1 mile mark and was 168 bpm. Signature with title • Recovery Pulse • Date, Time Recovery Pulse was taken 1 minute following the Queens College Step Test. P was recorded at 136 bpm. Signature with title.