Vital signs

Abstract

Executive summary Background Vital signs traditionally consist of blood pressure, temperature, pulse rate and respiratory rate, and are an important component of monitoring the patient’s progress during hospitalisation. An initial search of the literature indicated that there was a vast volume of published information relating to this topic; however, there had been no previous attempt to systematically review this literature. This review was therefore initiated to identify, appraise and summarise the best available evidence relating to the measurement of vital signs in hospital patients. Objectives The objectives of this review were to present the best available information related to the monitoring of patient vital signs with regard to their purpose, limitations, optimal frequency of measurements, and what measures should constitute vital signs. The review also sought to identify additional issues of importance related to the individual parameters of temperature measurement, blood pressure assessment, pulse rate measurement and respiratory rate measurement. Review methods This review considered all studies that related to the objectives and included neonatal, paediatric and/or adult hospital patients. The outcome measures of interest were those related to the accuracy of, required frequency of or the need for vital signs. The review also considered any study addressing some aspect of vital signs measurement to ensure all issues of importance were identified. The search sought to find both published and unpublished studies. Databases searched included CINAHL, Medline, Current Contents, Cochrane Library, Embase and Dissertation Abstracts. The references of all identified studies were examined for additional references. All studies were checked for methodological quality, and data was extracted using a data extraction tool. Results Although a variety of measures may be useful additions to the traditional four vital sign parameters, only pulse oximetry and smoking status have been shown to change patient care and outcomes. There are suggestions that vital sign monitoring has become a routine procedure, but little useful information was identified in regard to the optimal frequency of vital sign measurement. It was noted that many of the important issues related to vital sign measurement have not been investigated through research. There is currently only limited research related to respiratory rate as a vital sign; however, its value as an indicator of serious illness has not been reliably established. There is only limited research relating to pulse rate measurements. Although routinely used for all hospital patients, the ability to detect serious physiological changes by assessment of pulse rate has not been rigorously evaluated. Many factors were identified that could potentially influence the accuracy of blood pressure measurement. Auscultation is accurate for the measurement of systolic blood pressure using phase I Korotkoff sound as the reference point, and for diastolic pressure if phase V Korotkoff sound...

Clinical Relevance of Routinely Measured Vital Signs in Hospitalized Patients: A Systematic Review

“…Also, the definitions of “routine measurements” or “nonroutine measurements” are open for debate. This is in line with findings from other literature reviews of vital sign measurements, which conclude that there is a lack of explicit knowledge based on quantitative research (Evans et al., ; Lockwood, Conroy‐Hiller, & Page, ; Pedersen et al., ). This suggests that much of the current practice of routinely measuring vital signs in general hospitalized patients (as well as the accuracy, frequency, and usefulness for detecting clinically relevant outcomes) is based on tradition and not yet on evidence from research.…”

Critical care: the eight vital signs of patient monitoring

“…In the situation where an automated monitor gives varying BP readings, the BP should be assessed using a sphygmomanometer. In a systematic review, the use of auscultation to ensure accurate BP measurement is recommended (Lockwood et al, 2004).…”

Composite and Wearable Sensor Kit for Location Aware Healthcare Monitoring and Real-Time Trauma Scoring for Survival Prediction.

“…The four main vital signs like temperature, pulse rate/heart rate, respiration rate (rate of breathing), blood pressure (Non-invasive Systolic) and oxygen saturation were adequate to calculate trauma scores and prediction of survival. [7] [8] From the results obtained, stationary wavelet transform along with passband Chebyshev Type II order 2 filter, turned out effective in removing signal noise, motion artefacts and baseline wandering in ECG waveforms and yielding a better signal to noise ratio.…”

“…Vital signs have been widely used as performance indicators of a person's health. The four main vital signs that are routinely monitored by health care providers are Body temperature, Pulse rate/heart rate, Respiration rate (rate of breathing), Blood pressure (Non-invasive Systolic) [7] [8] The normal body temperature of a person varies depending on gender; recent activity person has been engaged in along with food and fluid consumption, the time of the day, and in women, the stage of the menstrual cycle. Normal body temperature can range from 97.8 degrees F (or Fahrenheit, equivalent to 36.5 degrees C, or Celsius) to 99 degrees F (37.2 degrees C) for an average healthy adult.…”