Medical Vital Signs

This medical examination routinely done and monitored by healthcare professionals to help assess the general health of a person. Vital signs are useful in detecting or monitoring medical problems. The normal ranges vary with person to person, age, weight, gender, and overall health. The four primary vital signs includes:

• Body temperature
• Pulse rate (Heart rate)
• Respiration rate (rate of breathing)
• Blood pressure

I.  Body temperature

The temperature obtained through a thermometer.  The temperature measured in either degrees Celcius (C) or degrees Farenheit (F). Normal body temperature can range from 97.8 degrees Fahrenheit to 99 degrees F, equivalent to 36.5 degrees C to 37.2 degrees C. The normal body temperature of a healthy person varies depending on gender, recent activity or exercise, the time of the day, and during menstrual period in women. Usually an elevated temperature (in fever) indicates signs of systemic infection or inflammation. 
Body temperature taken in any of the following methods:

Orally

It is by mouth placed under the tongue using either a classic glass thermometer or a digital thermometer that use an electronic probe to measure body temperature. This method is the preferred among adults.

Rectal/Anal

The temperature taken rectally using a glass or a digital thermometer. The thermometer inserted in the anus about 1 inch. The anal reading is 1 degree higher because it is higher than the core temperature compared to the oral method. This method is the preferred among children.

Axillary

The thermometer placed under the arm using a glass or a digital thermometer. The axillary reading will be 1 degree lower than those temperatures taken by mouth because it is not a core temperature reading. 

Tympanic

A special thermometer used for this reading. It go inside the ear to obtain the body's core temperature. 

Temporal

A special thermometer used to quickly measure the temperature of the skin on the forehead and swiped along one side of the face . 

Skin

These are strips that measure the patient's temperature. This method used when there is no other way to get the temperature reading available because the accuracy in not good. 

II.  Pulse Rate

This measures the number of times the heart beats per minute (BPM). It is the physical expansion of the artery as the heart pushes blood to the arteries. Taking the pulse rate will also determine the strength of the pulse and the heart rhythm. Pulse rate increases with exercise, illness, injury, and emotions. It varies with age. Infants have higher beats per minutes compared to adults. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side to measure radial pulse rate.

Normal Values

• Infant 100 to 130 bpm
• Child 80 to 100 bpm
• Adult 60 to 100 bpm

Pulse site

• Brachial
• Carotid
• Dorsal pedal
• Femoral popliteal
• Posterior tibial
• Radial
• Temporal
• Common sites: carotid and radial pulse sites

Related Terms

• Bradycardia is a condition of a heart rate consistently  below 100 bpm. Beating is too slow
• Tachycardia when the heart is above 100 bpm. Beating is too fast
• Strong/Regular pulse indicates that there is an adequate force and consistent beats
• Weak indicates a poor force contraction
• Irregular indicates arrhythmia. Out of normal rhythm

Peripheral Pulse Assessment Grading System

• 0-3 scale
• 0 absent
• 1+ weak/thready pulse
• 2+ normal
• 3+ full, firm pulse

Pulse Amplitude Classification

• 0 absent
• 1+ diminished
• 2+ normal
• 3+ moderately increased
• 4+ markedly increased

III. Respiratory Rate

The respiratory rate is the number of breaths a person takes per minute, that is inhalation-exhalation cycle. Respiration recorded as breaths per minute. It varies with age and increases with fever, illness, or other medical conditions.  Respiratory rate indicates a acidosis condition.

Inspiration - to breath air into the lungs
Expiration - to breath air out of the lungs

Normal Rate

• Infant 30 to 50 respiration per minute
• Adults 12 to 18 respiration per minute

IV.  Blood Pressure

Blood pressure is the force that moves blood through our circulatory system. 

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/Ab
outHighBloodPressure/Understanding-Blood-Pressure-
Readings_UCM_301764_Article.jsp

10 Guidelines in Shoe Fitting

A shoe is among the many products of footwear don on the foot basically for protection and comfort. Shoes are available in various classification such as style and design, specific function, sizes for adult and children, the gender of an individual, and others. They are either in a custom-made or in a ready-made items. Shoes can either create foot problem or help an individual with a foot problem. Instead of comfort and reason of use, an ill-fitted shoes develop or aggravate a foot deformity or add up to a pre-existing foot deformity, a poor blood circulation, a risk of musculoskeletal injuries, skin blisters and other serious medical conditions.

English: The foot of a person with Charcot-Marie-Tooth. The lack of muscle, high arch, and hammer toes are signs of the genetic disease. This patient was diagnosed with CMT-1A. Deutsch: atrophischer Hohlfuß bei hereditärer motosensibler Neuropathie I (Charcot-Marie-Tooth) (Photo credit: Wikipedia)

1.  The best time to measure your feet is in the afternoon or at end of the day because as the day progresses your feet become larger/swollen from various activities

2.  Stand up straight and with feet flat on the ground and ask someone to take the measurements.

 3.  The toes should have enough room to wiggle or move approximately 3/8 inch to ½ inch between the end of your longest toe and the end of the toe box and about the size of your thumb for side clearance. A tight shoe can create foot problems such as callus formation, corns, painful neuromas, and deformed toes. 

4.  No two feet are the same so fit your shoe with the larger foot. Extra pads and inserts that can take up room inside the shoe if it is too big. 

5.  Select a shoe that matches the general shape of your feet.

6.  Don't go for a very tight shoes and hope that some day it will stretch and comfortable to wear

7.  The height of the heel should be no more than 1½ inches. Higher the heel alter posture and gait producing excessive muscle fatigue and strain at the end of the day.

8.  Laced shoes are easier to adjust and easier to keep on the feet compared to slip-ons. When lacing up the shoe, the width of the lace holes should be the same all the way to the top to obtain proper fitting.

9.  Consider the type of foot, whether one has flat feet, high arches, or neutral feet. A high arch foot needs a well-cushioned shoe to improve shock absorption while a flat-footed individual needs a motion control to help limit excessive pronation.

10. I highly recommend that you go to a medical professional for foot problems or to an orthotist for a personalized shoe fitting.

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