Which vital sign should be taken first

Contact your local health department, waste disposal authority, or fire department for information on how to correctly dispose of mercury thermometers. The pulse rate is a measurement of the heart rate. This is the number of times the heart beats per minute. As the heart pushes blood through the arteries, the arteries expand and contract with the flow of the blood. Taking a pulse not only measures the heart rate, but also can indicate the following:.

The normal pulse for healthy adults ranges from 60 to beats per minute. The pulse rate may fluctuate and increase with exercise, illness, injury, and emotions. Females ages 12 and older, in general, tend to have faster heart rates than do males. Athletes, such as runners, who do a lot of cardiovascular conditioning, may have heart rates near 40 beats per minute with no problems.

As the heart forces blood through the arteries, you feel the beats by firmly pressing on the arteries, which are located close to the surface of the skin at certain points of the body.

The pulse can be found on the side of the neck, on the inside of the elbow, at the wrist, or in the groin. For most people, it's easiest to take the pulse at the wrist. If you use the lower neck, be sure not to press too hard. Never press on the pulses on both sides of the lower neck at the same time. This can block blood flow to the brain. Using the first and second fingertips, press firmly but gently on the arteries until you feel a pulse.

Count your pulse for 60 seconds or for 30 seconds and then multiply by 2 to calculate beats per minute. When counting, don't watch the clock continuously, but concentrate on the beats of the pulse. If your healthcare provider has asked you to check your own pulse and you are having trouble finding it, consult your provider or nurse for additional instruction. Many types of monitoring devices can help check your pulse.

These include fitness tracker devices to help track your pulse rate. The respiration rate is the number of breaths you take each minute.

The rate is usually measured when you are at rest. It simply involves counting the number of breaths for one minute by counting how many times your chest rises. Respiration rates may increase with exercise, fever, illness, and with other medical conditions. When checking respiration, it's important to also note whether you have any trouble breathing.

Normal respiration rates for an adult person at rest range from 12 to 20 breaths per minute. Blood pressure is the force of the blood pushing against the artery walls during contraction and relaxation of the heart. Each time the heart beats, it pumps blood into the arteries.

It results in the highest blood pressure as the heart contracts. When the heart relaxes, the blood pressure falls. Two numbers are recorded when measuring blood pressure.

The higher number is called systolic pressure. It refers to the pressure inside the artery when the heart contracts and pumps blood through the body. The lower number is called diastolic pressure. It refers to the pressure inside the artery when the heart is at rest and is filling with blood. High blood pressure directly increases the risk of coronary heart disease heart attack and stroke brain attack. With high blood pressure, the arteries may have an increased resistance against the flow of blood, causing the heart to pump harder to circulate the blood.

Respiratory rate: The respiration rate breathing rate is the number of breaths a person takes per minute. Normal respiration rates for a resting adult range from 12 to 16 breaths per minute. Respiration rates may increase with fever, illness, and with other medical conditions.

In many cases, changes in respiratory rate will be the first indication of a possible deterioration, much sooner than changes in other vital signs. SpO2: Also known as Oxygen Saturation, SpO2 is the fraction of oxygen saturated- hemoglobin relative to the total hemoglobin in the blood. Normal blood oxygen levels in humans are considered percent. Checklist 15 outlines the steps to take when checking vital signs.

Oral temperature: Place the thermometer in the mouth under the tongue and instruct patient to keep mouth closed. Leave the thermometer in place for as long as is indicated by the device manufacturer. Tympanic membrane ear temperature: Usually 0. The tympanic membrane shares the same vascular artery that perfuses the hypothalamus. Do not force the thermometer into the ear and do not occlude the ear canal. Use only when other routes are not available.

Apical pulse: Taken as part of a focused cardiovascular assessment and when the pulse rate is irregular. Apical heart rate should be used as the parameter indicated in certain cardiac medications e. Apical pulse rate should be taken for a full minute for accuracy, and is located at the fifth intercostal space in line with the middle of the clavicle in adults.

Carotid pulse: May be taken when radial pulse is not present or is difficult to palpate. Respiration rate:.