Vital Signs

Tom RaderStaff - June 8, 2021

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>core temperature between 96 and 100 degrees Fahrenheit

Would you be willing to add: 35 to 37 Celsius , for non-Americans?

I read that stethoscopes are one of the easiest tools to spread transmission of disease, but the least frequently cleaned. Is there any gear from a IFAK or gear that might be needed in an austere environment where keeping it clean and in good shape is important enough to mention?

 

Metric added 🙂

Great question on the cleanliness. When I first started learning this stuff, I was surprised to see/learn how not sterile much of the gear inside of an IFAK is. Medics will tell you it’s because dealing with these things in the field is never sterile, but that you’re unlikely to cause any problems because you’re almost never doing something invasive.

Since your stethoscope will likely only ever be touched by family members until the day comes you might use it on a random patient, it’s unlikely it would be transmitting something bad. 

And if you’re worried about it, use the hygiene wipes, alcohol, or whatever else you have to clean it off.

Some of the few things in an IFAK you want to keep clean / in protected packaging:

• NPA
• Gauze
• Needles
• Tweezers / forceps (for wound cleaning)

Tip: Things like needles can be stored inside your small container of liquid alcohol. Two problems solved at once!

 

The “at-rest” reference heart rates and breathing rates are great and very important to know. One thing I notice almost no one mention is what a realistic heart rate and breathing rate look like in a patient that just had something traumatic happen, or is still in that situation. Is there a general guideline of “expect it normal to 20% above normal” or it 100% depends on the patient and could be all over the place or it doesn’t matter because in that case you’re only paying attention to the trend?

 

I’m not aware of a rule-of-thumb like “expect someone after a car accident to have a bpm 20% higher than their typical at-rest.” Will flag for the first responders to see if they have patterns.

To your point, it’s the trend that matters. For example, my at-rest core body temperature is oddly low (around 97), and I’ve had false-negative diagnoses when the examiner only thought about average tables rather than the trend.  

 

Good question.

Short answer; not really.  We really want to strive to keep our patients’ vitals within the normal ranges as much as possible.

There are so many variables that can contribute to a patient’s vitals being abnormal; trauma, stress, environment, underlying health conditions, medications or illicit drugs (alcohol), etc.  Sure, someone who is injured may have an elevated pulse rate.  But that could be due to stress related to being injured or their body trying to compensate (look out, we’re about to go down a rabbit hole regarding “shock” lol) for blood loss due to that injury for example.  

Creating a log of vital signs certainly helps us identify trends, good or bad ones.