Vital signs Radiographers

1. TIPS FOR YOUR
HEALTH CARE
VITAL SIGNS

2. 1
Body
Temperature
2 3 4
VITAL SIGNS
Pulse Rate Respiratory
Rate
Blood
Pressure
are usually referred to the following
procedures used for assessment in
healthcare. They involve the:

3. RADIOGRAPHERS CAN TAKE
VITAL SIGNS
The radiographer must know how to measure each vital sign
to be prepared in case an emergency situation in which
these skills are needed is ever encountered.
Radiographers do not take vital signs on most patients, and
when the need does arise, it is often in response to an urgent
situation.

4. WHEN PATIENT COMES
IN THE DIAGNOSTIC
IMAGING DEPARTMENT
for an extensive procedure or examination
without a chart and no registered nurse is
available.
RADIOGRAPHER MUST KNOW HOW TO MEASURE EACH
VITAL SIGN TO BE PREPARED IN CASE AN EMERGENCY
SITUATION
NOTE
A physician’s order is not required for vital signs to be
measured. Unless a registered nurse is present to do so.

5. WHEN PATIENT COMES
IN THE DIAGNOSTIC
IMAGING DEPARTMENT
before and after the patient receives medication,
any time the patient’s general condition
suddenly changes, or if the patient reports
nonspecific symptoms of physical distress such
as simply not feeling well or feeling “different.”
VITAL SIGNS MUST BE MEASURED BY
THE RADIOGRAPHER
NOTE

6. A QUICK REFERENCE TO NORMAL
VITAL SIGNS BY AGE

7. VITAL SIGNS:
BODY
TEMPERATURE

8. BODY TEMPERATURE
is the physiologic balance between heat
produced in body tissues and heat lost to
the environment.
controlled by a small structure in the basal
region of diencephalon of the brain called
the hypothalamus.

9. Environment Time of Day Age Weight Hormone
Levels
FACTORS THAT INFLUENCE BODY
TEMPERATURE

10. Emotions Physical
Exercise
Digestionof
food
Disease Injury
FACTORS THAT INFLUENCE BODY
TEMPERATURE

11. BODY TEMPERATURE
A patient whose body temperature is
elevated above normal limits is said to
have a fever, or pyrexia.
Fever indicates a disturbance in the heat-
regulating centers of the body, usually as
a result of a disease process. As body
temperature increases, the body’s
demand for oxygen increases.

12. BODY TEMPERATURE
increased pulse and respiratory rate
general discomfort or aching
flushed dry skin that feels hot to the touch
chills (occasionally)
loss of appetite
SYMPTOMS OF A FEVER
A person with a body temperature below
normal limits is said to have hypothermia,
which may beindicative of a pathological
process.

13. BODY TEMPERATURE RANGE

14. MEASURING BODY
TEMPERATURE
the oral site
the tympanic site
the rectal site
the axillary site.
There are four areas of the body in which
temperature is usually measured in:

15. MEASURING BODY TEMPERATURE
Oral temperature is taken by mouth under the tongue; the
average oral temperature reading is 98.6F (37C).
The axillary temperature is taken in the axilla or armpit. The
average axillary temperature is 97.6F to 98F (36.4C to 36.7C).
Rectal temperature is taken at the anal opening to the
rectum. The average rectal temperature is 99.6F (37.5C).
Tympanic temperature is 0.3 C (0.5 F) to 0.6 C (1 F) .

16. RADIOGRAPHERS MEASURING
BODY TEMPERATURE
washing the hands
wearing gloves
Whatever method of measuring body temperature is
chosen, the radiographer must assemble the necessary
equipment and abide by medically aseptic technique such
as:
if there is a possibility of coming in contact with blood or
other body fluids.

17. PROCEDURES OF MEASURING BODY
TEMPERATURE
(also called an aural thermometer) is a small,
hand-held device that measures the
temperature of the blood vessels in the tympanic
membrane of the ear. This provides a reading
close to the core body temperature if correctly
placed. The patient may be sitting upright or in a
supine position.
TYMPANIC MEMBRANE THERMOMETER

18. PROCEDURES OF MEASURING BODY
TEMPERATURE
1. Place a clean sheath on the probe that is to be inserted into the external auditory
canal
2. Place the probe into the external auditory canal and hold it firmly in place until the
temperature registers automatically on the meter held in the non-dominant hand.
3. Remove the probe and read the indicator.
4. Remove the probe’s cover and dispose of it correctly. Remove any gloves and wash
hands.
5. Record the reading. Immediately report any abnormal temperature to the
radiologist in charge of the procedure.
THE PROCEDURE FOR USE IS:

19. PROCEDURES OF MEASURING BODY
TEMPERATURE
the probe is placed under the patient’s
tongue
held in place until the instrument signals that
it has registered a temperature.
The procedure for the electronic thermometer is
the same as for the tympanic membrane
thermometer, except:
ELECTRONIC THERMOMETER FOR ORAL TEMPERATURE

20. PROCEDURES OF MEASURING BODY
TEMPERATURE
Use of the axillary site is the safest method of
measuring body temperature because it is
noninvasive. It is particularly useful when
measuring an infant’s temperature. When it is
necessary to measure temperature using the
axillary site, an electronic or disposable
thermometer may be used.
TAKING AN AXILLARY TEMPERATURE

21. PROCEDURES OF MEASURING BODY
TEMPERATURE
1. Obtain the instrument to be used.
2. After putting on clean gloves, dry the patient’s armpit with a paper towel
or dry washcloth.
3. Place the thermometer into the center of the armpit.
4. Place the patient’s arm down tightly over the thermometer with the arm
crossed over the chest. Gently hold the arm of a child or a restless adult in
place until the thermometer has registered, usually about 1 minute.
THE PROCEDURE IS AS FOLLOWS:

22. PROCEDURES OF MEASURING BODY
TEMPERATURE
5. Remove the thermometer and read the temperature.
6. Record the reading and dispose of the thermometer as appropriate.
THE PROCEDURE IS AS FOLLOWS:

23. PROCEDURES OF MEASURING BODY
TEMPERATURE
The rectal site is considered to provide the most reliable measurement of
body temperature because factors that can alter the results are minimized.
Body temperature should not be measured rectally if the patient is restless
or has rectalpathology such as tumors or hemorrhoids.
To take a rectal temperature, use a thermometer with a blunt tip. Never use
an oral thermometer to take a rectal temperature. Probe covers are often
colored red for rectal temperature.
TAKING A RECTAL TEMPERATURE

24. PROCEDURES OF MEASURING BODY
TEMPERATURE
1. Obtain the correct thermometer.
2. Put on clean gloves.
3. Assure the patient’s privacy and place him or her in the Sim’s position.
4. Expose only as much of the patient as necessary for clear viewing of the
rectal area.
5. Lubricate the thermometer tip (or probe cover if one is used) with
lubricating gel
THE PROCEDURE IS AS FOLLOWS:

25. PROCEDURES OF MEASURING BODY
TEMPERATURE
6. Separate the patient’s buttocks with the heel of one
hand so that rectum is clearly visible.
7. Gently insert the tip of the thermometer into the rectum about 1 to 1.5
inches and hold it in place for 2 to 3 minutes. Do not leave a patient with a
rectal thermometer in place. It must be held in place for an accurate
reading.
8. Remove the thermometer, read it, and dispose of it as appropriate.
THE PROCEDURE IS AS FOLLOWS:

26. PROCEDURES OF MEASURING BODY
TEMPERATURE
9. After removing the gloves in the correct manner and performing a
minimum 30-second hand wash, record the temperature.
THE PROCEDURE IS AS FOLLOWS:

27. VITAL SIGNS:
PULSE

28. As the heart beats, blood is pumped in a pulsating
fashion into the arteries. This results in a throb, or
pulsation, of the artery. At areas of the body in which
arteries are superficial, the pulse can be felt by holding
the artery beneath the skin against a solid surface such
as bone.
PULSE

29. Apical pulse:
over the apex of
the heart (heard
with a
stethoscope)
Radial pulse: over
the radial artery
at the wrists
at the base of
the thumb
Carotid pulse:
over the carotid
artery at the
front of the
neck
Femoral pulse:
over the femoral
artery in the
groin
Popliteal pulse:
at the posterior
surface of the
knee
THE PULSE CAN BE DETECTED MOST
EASILY IN THE FOLLOWING
AREAS OF THE BODY:

30. Temporal pulse:
over the
temporal artery
in
front of the ear
Dorsalis pedis pulse
(pedal): at the top of the
feet in line with the
groove between the
extensor
tendons of the great
and second toe (may be
congenitally absent)
Posterior tibial
pulse: on the
inner side of the
ankles
Brachial pulse: in the
groove between the
biceps
and triceps muscles
above the elbow at
the antecubital
fossa
THE PULSE CAN BE DETECTED MOST
EASILY IN THE FOLLOWING
AREAS OF THE BODY:

31. the pulse rate is rapid if the blood pressure is low and slower if the blood
pressure is high.
The normal average pulse rate in an adult man or woman in a resting
state is between 60 and 90 beats/min.
The normal average pulse rate for an infant is 120 beats/min.
A child from 4 to 10 years of age has a normal average pulse rate of 90 to
100 beats/min.
PULSE

32. The heart rate is measured in beats per minute (BPM).
Tachycardia (abnormally rapid pulse) occurs when the heart
rate is greater than 100 BPM. This may be temporary, as a
result of exertion, nervousness, or excitability, but can also be
caused by a damaged heart.
PULSE

33. Place your fingers over the artery with your thumb on the
back of the wrist and compress gently but firmly.
By compressing the artery against the radius, the pulse is
easy to feel, especially if the patient's wrist is held palm
down.
When the radial pulse rate is taken routinely, it is common
to count for 15 seconds and then multiply the result by 4.
Whenever there is an irregular rate or rhythm, count for a
full 60 seconds.
HOW TO LOCATE THE PULSE

34. ASSESSMENT OF THE
PULSE
The radial pulse is usually the most accessible and can be taken
most conveniently on an adult patient.
The apical pulse is used to monitor if the radial pulse is
inaccessble. Listening through a stethoscope.
If a registered nurse is not present to take the pulse rate, be prepared
to make this assessment before beginning any invasive diagnostic
imaging procedure in order to establish a baseline reading and to
reassess it frequently until the procedure is complete and the patient
leaves the department.

35. ASSESSMENT OF THE
PULSE
For infants and children, the apical pulse is the most accurate for
cardiovascular assessment.
The femoral, popliteal, and pedal pulses are assessed bilaterally if
peripheral blood flow is to be assessed

36. ASSESSMENT OF THE
PULSE
The normal rhythm of the pulse beat is regular, with equal time
intervals between beats.
If the beat is irregular, unusually rapid, unusually slow, or unusually
weak, immediately report this to the physician in charge of the
patient.
Changes in pulse rate duringa procedure must also be reported
When assessing pulse rate, report the strength and regularity of the
beat as well as the number of beats per minute.
Radiographer must know:

37. ASSESSMENT OF THE
PULSE
Equipment need:
watch with a second hand
and a pad and pencil to
record the findings
For monitoring the apical
pulse:
a stethoscope that has been
cleaned will be needed.
BE CAREFUL NOT TO PRESS TOO HARD WITH
THE FINGER OR THE
PULSE WILL BE COMPRESSED AND NOT FELT.
C A L L O U T !
DO NOT USE THE THUMB TO COUNT THE
PULSE BECAUSE IT HAS ITS OWN PULSE.
C A L L O U T !

38. RESPIRATOR RATE The function of the Respiratory system is
to exchange oxygen and carbon dioxide
between the external environment and
the blood circulating in the body.
The average rate of respiration (one inspiration and
one expiration) for an adult man or woman is 15 to
20 breath/min, and for an infant it is 30 to 60
breath/min.
Respiration of fewer than 10 breaths/min for an adult may result in
CYNOSIS. When a patient is using more than the normal effort to
breath, he or she is described as dyspneic or as having DYSPNEA.
BRADYPNEA - Slow breathing with fewer than 12 breaths per
minute .
TACHYPNEA - Rapid breathing in excess 20 breaths per minute .
To count respirations, simply note the number of inhalation per
minute. This is often done while continuing to hold the wrist after the
pulse has been counted, since some patients may force a change in
the respiratory rate if aware that a count is being made.

39. ASSESSMENT OF RESPIRATION
As with other vital signs, it is important to establish a baseline respiratory rate because
changes in respiration are often an early sign of threatened physiologic state.
REMEMBER, That the rate of respiration increases with:
Physical Exercise Emotion
Respiration is also
quicker in
newborns and
infants.
When assessing respiration, observe the rate, depth, quality, and pattern.

40. ASSESSMENT OF RESPIRATION
The assessment procedure is as follows:
Keep the patient in a seated or supine.
Observe the chest wall for symmmetry of movement .
observe skin color
Count the number of times the patient's chest rises and
falls for 1 minute.
If a patient complains of dyspnea ( difficult of breathing ), or exhibits an abnormal respiratory
rate , you should inform the radiologist and prepare oxygen equipment for immediate use if
ordered.
Remember: When recording respiration, use the abbreviation R. R 20 equals 20 rises and falls of
the chest wall. Any abnormalities or deviation from the baseline should be reported tro the
physician in charge of of the patient and recorded, for example, R28, shallow and labored.

41. BLOOD PRESSURE
Age
Gender
Physical development
Body posotion
Time of day
Health status
Pressure is defined as the product of flow times resistance.
Blood Pressure is the amount of blood flow ejected from
the left ventricle of the heart during systole and amount of
resistance the blood meets due to systemic vascular
resistance.
Blood pressure normally varies with :

42. Blood pressure is usually lower in the morning after a night of sleep than later in
the day after activity.
Blood pressure increases after a large intake of food. Emotions and strenuous
activity usually cause systolic blood pressure to increase.
HYPERTENSION (Abnormally high blood pressure)
BLOOD PRESSURE
Hypertension is more common in men before the age of 50 and in
women after age of 50. In aging population, the incidence of
hypertension gradually increase until approximately 30% of
individuals will show some elevation above normal.
HYPOTENSION(Abnormally low blood pressure)
Hypotension can result in a potentially life threatening condition
called SHOCK.

43. The Instrument used to measure blood pressure SPHYMOMANOMETER (equipment
using stethoscope and blood pressure cuff).
EQUIPMENT NEEDED TO MEASURE BLOOD
PRESSURE
Two numbers, read in millimeters of mercury (mm Hg), are recorded when reporting blood
pressure : Systolic pressure and Diastolic pressure.
The SYSTOLIC reading is the highest point reached during contraction of the left
ventricle of the heart as it pumps blood into the aorta.
The DIASTOLIC pressure is the lowest point to which the pressure drops during
relaxation of the ventricles and indicates the minimal pressure exerted against the
arterial wall continuously.
In men and women, the normal ranges are 90 to 120 mm Hg for systolic pressure and 50 to
70 mm Hg for diastolic pressure. Adolescent patients' blood pressure ranges from 85 to 130
mm Hg systolic and 45 to 85 mm Hg diastolic.

44. EQUIPMENT NEEDED TO MEASURE BLOOD
PRESSURE
Mercury manometer Aneroid manometer Electronic

45. There are three types of sphygmomanometers, a mercury manometer, Aneroid
manometer and Electronic.
EQUIPMENT NEEDED TO MEASURE BLOOD
PRESSURE
The Mercury manometer is more accurate of the two but it is less convenient to use.
traditional mercury-gravity instrument have been phased out in response to the OSHA.
The Aneroid manometer needle should point to zero before the bladder of cuff is
inflated. Aneroid manometer are the type most often found in the radiology
department., because this procedure is most frequently used in an emergency, it is
important to be proficient before the need arises.
An Automated vital sign monitor is uses during special diagnostic imaging procedures
when it is necessary to know the patient's circulatory status at all times. The pulse,,
blood pressure and mean arterial pressure are measured with this instrument.

46. MEASURING
BLOOD
PRESSURE

47. LOCATION ON MEASURING BLOOD PRESSURE

48. NORMAL VALUES

49. THANK
YOU!
THANK
YOU!