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Diagnostic Equipment for. Vital Signs Devices. The Welch Allyn Spot Vital Signs® monitor provides vital signs in seconds with hospital-grade technology.
Aug 22, 2013 Tools, Equipment, and Paraphernalia for Taking Vital Signs BP Apparatus Aneroid (sphygmomanometer) An aneroid unit is mercury free and consists of a cuff that can be applied with one hand for self-testing; a stethoscope that is built in or attached; and a valve that inflates and deflates automatically with the data displayed on an easy-to-read. Exescope 6.50 full download.
1treated as singular or pluralMiscellaneous articles, especially the equipment needed for a particular activity.
‘drills, saws, and other paraphernalia necessary for home improvements’
- ‘I would contend a crucial first step in the fight against bigotry is to ban the vendors outside the grounds who sell the paraphernalia which causes most offense.’
- ‘Despite all the tools and paraphernalia, many people feel that the most important ingredient is the Witch.’
- ‘Only most incidents pass unreported because they occur away from the ground and the accompanying paraphernalia of cameras and notebooks.’
- ‘Apart from the sponsor company's paraphernalia, there were big displays of chessboards.’
- ‘A party ensued, with marquees blasting out music and a market area selling drugs and festival paraphernalia such as glow sticks.’
- ‘They, in spite of the most expensive and elaborate defense paraphernalia of the US Government, feel defenseless.’
- ‘Through this, my dad slowly but surely built a reputation for quality and timely delivery of printed paraphernalia.’
- ‘Begrudgingly, the guru agreed and the priest left to collect the necessary paraphernalia.’
- ‘Various other bits and pieces of paraphernalia or equipment in the process can be a source of infection for Hep-C as well.’
- ‘But it must go much farther than merely banning the sale of paramilitary paraphernalia near the club grounds.’
- ‘We still have the human resources at all levels and we still have the equipment and paraphernalia for general elections.’
- ‘Both of my boys have been raised around computer paraphernalia and tools.’
- ‘Various other equipment and military paraphernalia have been found in the area over the years.’
- ‘A UN flag and an Indian flag now form part of his paraphernalia in the travel kit.’
- ‘Around £2,000 cash was also found along with drug paraphernalia including scales and cutting boards.’
- ‘Drug paraphernalia and empty wine bottles lay strewn among layers of rotting food, dirty cardboard boxes and stinking blankets.’
- ‘Of course, no one could prove that, as he had all of the necessary ID, credit cards, and other paraphernalia.’
- ‘At one event, a giant Christmas cracker had been lowered to the ground containing all manner of party paraphernalia including party balloons and hats.’
- ‘Pro shooters walk around with those funny khaki vests with large pockets all over them stuffed with paraphernalia and lenses.’
- ‘Items on auction include left over shop stock, fittings, computer equipment and other environmental paraphernalia.’
equipment, stuff, things, apparatus, tackle, kit, implements, tools, utensils, material, materials, appliances, rig, outfit, accoutrements, appurtenances, impedimenta, miscellaneous articles, odds and ends, bits and pieces, bits and bobs, trappings, accessories
- 1.1Trappings associated with a particular institution or activity that are regarded as superfluous.
- ‘Though these comforts are the paraphernalia associated with aristocrats, priority for the same assumes a logic.’
- ‘At the focus of the pueblo was a large plaza in which was a great kiva flanked by rectangular rooms, possibly storerooms for food and ritual paraphernalia.’
- ‘He looked around pointedly at the ritual paraphernalia which surrounded us.’
- ‘The basic paraphernalia associated with a Mumbai beachside is in the Temple City, albeit for a limited period.’
- ‘The theatre and paraphernalia of church ritual were rejected, as was the distinction between clergy and laity.’
- ‘Most of the paraphernalia we have come to associate with funerals today is of Victorian invention and aesthetic.’
belongings, luggage, baggage, effects, supplies, provisions, trappings, appurtenances, impedimenta
Mid 17th century (denoting property owned by a married woman): from medieval Latin, based on Greek parapherna ‘property apart from a dowry’, from para ‘distinct from’ + pherna (from phernē ‘dower’).
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An anesthetic machine with integrated systems for monitoring of several vital parameters, including blood pressure and heart rate
|Purpose||assess the general physical health of a person|
Vital signs (often shortened to just vitals) are a group of the 4 to 6 most important signs that indicate the status of the body’s vital (life-sustaining) functions. These measurements are taken to help assess the general physical health of a person, give clues to possible diseases, and show progress toward recovery. The normal ranges for a person’s vital signs vary with age, weight, gender, and overall health.
There are four primary vital signs: body temperature, blood pressure, pulse (heart rate), and breathing rate (respiratory rate), often notated as BT, BP, HR, and RR. However, depending on the clinical setting, the vital signs may include other measurements called the 'fifth vital sign' or 'sixth vital sign'. Vital signs are recorded using the LOINC internationally accepted standard coding system.
Early warning scores have been proposed that combine the individual values of vital signs into a single score. This was done in recognition that deteriorating vital signs often precede cardiac arrest and/or admission to the intensive care unit. Used appropriately, a rapid response team can assess and treat a deteriorating patient and prevent adverse outcomes.
- 1Primary vital signs
- 2Other signs
Primary vital signs
There are four primary vital signs which are standard in most medical settings:
- Heart rate or Pulse
The equipment needed is a thermometer, a sphygmomanometer, and a watch. Though a pulse can be taken by hand, a stethoscope may be required for a patient with a very weak pulse.
Temperature recording gives an indication of core body temperature which is normally tightly controlled (thermoregulation) as it affects the rate of chemical reactions. Body temperature is maintained through a balance of the heat produced by the body and the heat lost from the body.
Temperature can be recorded in order to establish a baseline for the individual's normal body temperature for the site and measuring conditions. The main reason for checking body temperature is to solicit any signs of systemic infection or inflammation in the presence of a fever (temp > 38.5 °C/101.3 °F or sustained temp > 38 °C/100.4 °F), or elevated significantly above the individual's normal temperature. Other causes of elevated temperature include hyperthermia.
Temperature depression (hypothermia) also needs to be evaluated. It is also noteworthy to review the trend of the patient's temperature. A fever of 38 °C is not necessarily indicate an ominous sign if the patient's previous temperature has been higher.
The pulse is the rate at which the heart beats while pumping blood through the arteries, recorded as beats per minute (bpm). It may also be called 'heart rate'. The pulse is commonly taken at the wrist (radial artery). Alternative sites include the elbow (brachial artery), the neck (carotid artery), behind the knee (popliteal artery), or in the foot (dorsalis pedis or posterior tibial arteries). The pulse rate can also be measured by listening directly to the heartbeat using a stethoscope. The pulse varies with age: a newborn or infant can have a heart rate of 130–150 bpm, a toddler of 100–120 bpm, an older child of 60–100 bpm, an adolescent of 80–100 bpm, and an adult of 50–80 bpm.
Average respiratory rates vary between ages, but the normal reference range for people age 18 to 65 is 16–20 breaths per minute. The value of respiratory rate as an indicator of potential respiratory dysfunction has been investigated but findings suggest it is of limited value. Respiratory rate is a clear indicator of acidotic states, as the main function of respiration is removal of CO2 leaving bicarbonate base in circulation.
Main article: Blood pressure § Measurement
The blood pressure is recorded as two readings: a high systolic pressure, which occurs during the maximal contraction of the heart, and the lower diastolic or resting pressure. A normal blood pressure would be 120 being the systolic over 80, the diastolic. Usually the blood pressure is read from the left arm unless there is some damage to the arm. The difference between the systolic and diastolic pressure is called the pulse pressure. The measurement of these pressures is now usually done with an aneroid or electronic sphygmomanometer. The classic measurement device is a mercury sphygmomanometer, using a column of mercury measured off in millimeters. In the United States and UK, the common form is millimeters of mercury, whilst elsewhere SI units of pressure are used. There is no natural 'normal' value for blood pressure, but rather a range of values that on increasing are associated with increased risks. The guideline acceptable reading also takes into account other co-factors for disease. Therefore, elevated blood pressure (hypertension) is variously defined when the systolic number is persistently over 140–160 mmHg. Low blood pressure is hypotension. Blood pressures are also taken at other portions of the extremities. These pressures are called segmental blood pressures and are used to evaluate blockage or arterial occlusion in a limb (see Ankle brachial pressure index).
In the U.S., in addition to the above four, many providers are required or encouraged by government technology-in-medicine laws to record the patient's height, weight, and body mass index. Unlike the traditional vital signs, these measurements are not useful for assessing acute changes in state because of the rate at which they change; however, they are useful for assessing the impact of prolonged illness or chronic health problems.
The definition of vital signs may also vary with the setting of the assessment. EMTs (Emergency Medical Technicians), in particular, are taught to measure the vital signs of: respiration, pulse, skin, pupils, and blood pressure as 'the 5 vital signs' in a non-hospital setting.
Fifth vital signs
The 'fifth vital sign' may refer to a few different parameters.
- Pain is considered a standard fifth vital sign in some organizations such as the U.S. Veterans Affairs. Pain is measured on a 0-10 pain scale based on subjective patient reporting and may be unreliable. Some studies show that recording pain routinely may not change management.
- Menstrual cycle
- Oxygen saturation (as measured by pulse oximetry)
- Blood Glucose level 
Sixth vital signs
There is no standard 'sixth vital sign'; its use is more informal and discipline-dependent than the above.
- End-tidal CO
- Functional status
- Shortness of breath
- Gait speed
- Delirium 
Variations by age
Reference ranges for blood pressure
|Range||Typical example||Range||Typical example|
|Infants||1 to 12 months||75-100||85||50–70||60|
|Toddlers||1 to 4 years||80-110||95||50–80||65|
|Preschoolers||3 to 5 years||80-110||95||50–80||65|
|School age||6 to 13 years||85-120||100||55–80||65|
|Adolescents||13 to 18 years||95-140||115||60–90||75|
Children and infants have respiratory and heart rates that are faster than those of adults as shown in the following table:
|Age||Normal heart rate|
(beats per minute)
|Normal respiratory rate|
(breaths per minute)
|Range||Typical example||Range||Typical example|
|15–20 years||60–100||80||12–30||20|
Monitoring of vital parameters most commonly includes at least blood pressure and heart rate, and preferably also pulse oximetry and respiratory rate. Multimodal monitors that simultaneously measure and display the relevant vital parameters are commonly integrated into the bedside monitors in intensive care units, and the anesthetic machines in operating rooms. These allow for continuous monitoring of a patient, with medical staff being continuously informed of the changes in general condition of a patient.
While monitoring has traditionally been done by nurses and doctors, a number of companies are developing devices which can be used by consumers themselves. These include Scanadu and Azoi.
Tools Equipment And Paraphernalia For Taking Vital Signs
- ^'Vital Signs'.
- ^'Vital Signs Table - ProHealthSys'.
- ^'Logical Observation Identifiers Names and Codes'.
- ^'LOINC - A Lingua Franca Critical for Electronic Medical Records and Health Information Exchange'.
- ^National Early Warning Score Development and Implementation Group (NEWSDIG) (2012). National Early Warning Score (NEWS): standardising the assessment of acute-illness severity in the NHS. London: Royal College of Physicians. ISBN978-1-86016-471-2.
- ^National Institute for Health and Clinical Excellence. Clinical guideline 50: Acutely ill patients in hospital. London, 2007.
- ^'Acute care toolkit 6: the medical patient at risk: recognition and care of the seriously ill or deteriorating medical patient'(PDF). Royal College of Physicians of London. May 2013.
- ^(RCP 2012)[clarification needed]
- ^'What should I include when I record vital signs of my patients for MU? - Providers & Professionals - HealthIT.gov'.
- ^Emergency Care, 11th edition, pp. 226–244.
- ^Lorenz, Karl A.; Sherbourne, Cathy D.; Shugarman, Lisa R.; Rubenstein, Lisa V.; Wen, Li; Cohen, Angela; Goebel, Joy R.; Hagenmeier, Emily; Simon, Barbara; Lanto, Andy; Asch, Steven M. (1 May 2009). 'How Reliable is Pain as the Fifth Vital Sign?'. J Am Board Fam Med. 22 (3): 291–298. doi:10.3122/jabfm.2009.03.080162. PMID19429735 – via www.jabfm.org.
- ^'Tips From Other Journals - American Family Physician'.
- ^Mularski RA, White-Chu F, Overbay D, Miller L, Asch SM, Ganzini L (2006). 'Measuring pain as the 5th vital sign does not improve quality of pain management'. J Gen Intern Med. 21 (6): 607–12. doi:10.1111/j.1525-1497.2006.00415.x. PMC1924634. PMID16808744.
- ^American College of Obstetricians and Gynecologists. (2015). 'Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Committee Opinion No. 651'. Obstet Gynecol. 126: 143–6.
- ^American Academy of Pediatrics, Committee on Adolescence, American College of Obstetricians and Gynecologists, Committee on Adolescent Health Care. (2006). 'Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign'. Pediatrics. 118 (5).CS1 maint: Multiple names: authors list (link)
- ^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. doi:10.1111/j.1553-2712.1998.tb02813.x. PMID9754497.
- ^Mower W, Sachs C, Nicklin E, Baraff L (1997). 'Pulse oximetry as a fifth pediatric vital sign'. Pediatrics. 99 (5): 681–6. CiteSeerX10.1.1.575.2200. doi:10.1542/peds.99.5.681. PMID9113944.
- ^Neff T (1988). 'Routine oximetry. A fifth vital sign?'. Chest. 94 (2): 227. doi:10.1378/chest.94.2.227a. PMID3396392.
- ^'Mining Vital Signs from Wearable Healthcare Device via Nonlinear Machine Learning'. University of Hull. Retrieved 2016-05-14.
- ^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. PMID10979461.
- ^Holcomb JB, Salinas J, McManus JM, Miller CC, Cooke WH, Convertino VA (2005). 'Manual vital signs reliably predict need for life-saving interventions in trauma patients'. J Trauma. 59 (4): 821–8, discussion 828–9. doi:10.1097/01.ta.0000188125.44129.7c. PMID16374268.
- ^Bierman A (2001). 'Functional Status: The Sixth Vital Sign'. J Gen Intern Med. 16 (11): 785–6. doi:10.1111/j.1525-1497.2001.10918.x. PMC1495293. PMID11722694.
- ^'Nursing care of dyspnea: the 6th vital sign in individuals with chronic obstructive pulmonary disease (COPD)'. National Guideline Clearinghouse. Archived from the original on 2009-01-17. Retrieved 2009-01-16.
- ^Studenski S, Perera S, Wallace D, et al. (2003). 'Physical performance measures in the clinical setting'. J Am Geriatr Soc. 51 (9): 314–322. doi:10.1046/j.1532-5415.2003.51104.x. PMID12588574.
- ^ abcdefghijPEDIATRIC AGE SPECIFIC, page 6. Revised 6/10. By Theresa Kirkpatrick and Kateri Tobias. UCLA Health System
- ^Emergency Care, Page 214
- ^Emergency Care, Page 215
- ^Vorvick, Linda. 'Pulse'. MedlinePlus. U.S. National Library of Medicine. Retrieved 23 January 2011.
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