Vital Signs and SAMPLE History
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1 CHAPTER 9 Vital Signs and SAMPLE History
2 Overall Assessment Scheme Scene Size-Up Initial Assessment Trauma Physical Exam Vital Signs & SAMPLE History Medical SAMPLE History Physical Exam & Vital Signs Detailed Physical Exam Ongoing Assessment HOSP
3 Baseline Vital Signs
4 Baseline Vital Signs Pulse Respirations Skin Pupils Blood Pressure
5 Pulse
6 Pulse Rate Adults generally /minute. Tachycardia is pulse more than 100/minute. Bradycardia is pulse less than 60/minute. More than 120 or less than 50 may be a critical finding.
7 Pulse Quality Strong or weak Regular or irregular
8 If you cannot feel a radial or brachial pulse, check the carotid pulse.
9 Respirations
10 Respiratory Quality Normal Shallow Labored Noisy
11 Check skin color, temperature, and condition.
12 Abnormal Skin Colors Pale Cyanotic Flushed Jaundiced
13 Abnormal Skin Temperature Hot Cool Cold
14 Abnormal Skin Condition Wet Very dry
15 Infants and Children: Check capillary refill.
16 Pupils
17 Abnormal Pupil Conditions
18 Pupils Size Dilated Constricted Equality Reactivity To light Nonreactive (fixed)
19 Blood Pressure
20 Blood pressure is described as: Systolic Diastolic or
21 Measuring Blood Pressure Palpation Auscultation
22 Pulse Oximetry Measures oxygen circulating in the blood % considered normal
23 Pulse Oximeter
24 Pulse Oximetry Precautions Not accurate in shock or hypothermia. False readings in carbon monoxide poisoning. Movement and nail polish can cause inaccurate readings. Batteries must be in good condition.
25 Pulse Oximetry NOTE! Do not withhold oxygen from a patient who may need it because the oximeter reads normal.
26 Reassessment of Vital Signs Stable patient (every 15 minutes) Unstable patient (every 5 minutes)
27 SAMPLE History
28 SAMPLE History S A M P L E = Signs and symptoms = Allergies = Medications = Pertinent past history = Last oral intake = Events leading to injury or illness
29 Signs and Symptoms Signs: : smell, seen, feel, hear Symptoms: : cannot observe patient tells you
30 Allergies To medications To foods To environment
31 Medications Prescription & Non-prescription Current Recent Birth control pills
32 Pertinent past history should include medical, surgical, and trauma factors.
33 Last Oral Intake
34 Events Leading to Illness or Injury Sequence of events that led to illness or injury
35 Interview Strategies Position yourself appropriately. Identify yourself. Speak in a normal voice. Use your patient s name.
36 Review Questions 1. List the five vital signs an EMT should record. 2. What characteristics should you look for when evaluating: Pulse? Respirations? Skin?
37 Review Questions 3. Explain how to get a SAMPLE history. 4. How often should you reevaluate vital signs?
38 STREET SCENES What is your primary concern for this patient? What vital signs should be taken even if a no transport decision is being considered?
39 STREET SCENES If given the opportunity, what should the patient history include? What other patient history information should be obtained?
40 STREET SCENES Should you take another set of vital signs? How might you get the patient to rethink her decision not to be transported?
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