Vital signs provide a glimpse of what might be going on inside the human body. By monitoring key vial signs, occupational therapists can not only assess client tolerance of tasks and activities, but can also detect potential concerns and take the appropriate course of action to avoid injury to the client.
Pulse or Heart Rate
Pulse, or heart rate, is the number of heart beats per minute. The normal resting heart rate for adults ranges between 60 and 100 beats per minute, with values higher in children. Heart rate generally decreases with increased physical conditioning and decreases with increasing age. Tachycardia refers to an increased heart rate of more than 100 beats per minute in adults, and bradycardia refers to a decreased heart rate of less than 60 beats per minute in adults. Causes of increased heart rate may include exercise, anxiety, fever, high blood pressure, medication side effects, or heavy caffeine or alcohol consumption. A normal heart rate during exercise can be calculated by subtracting age from 220.
Pulse can be measured manually or through use of a pulse oximeter.
Blood Pressure
Blood pressure is the force of the blood as it is pumped through the body. The average adult blood pressure is 120/88 mm Hg, but this value can vary significantly between individuals. Unlike other vital signs, blood pressure generally increases with age. It is generally higher in overweight individuals. Blood pressure temporarily increases with exercise, anxiety, or pain and decreases with severe dehydration.
Blood pressure can be measured using an automatic blood pressure monitor or a manual cuff and stethoscope.
Oxygen Saturation
Oxygen saturation refers to the amount of hemoglobin in the arteries that is bonded to oxygen in order to approximate the amount of available oxygen in the blood. Normal oxygen saturation rates are 97-99%. Oxygen saturation rates decrease with increased activity. Because these values are dependent upon the amount of hemoglobin that is bonded to oxygen rather than on the amount of oxygen, individuals with medical conditions such as anemia or carbon monoxide poisoning may still be at risk for oxygen deprivation despite registering normal oxygen saturation readings.
Oxygen saturation levels can be measured through use of a pulse oximeter.
Respirations
Respiratory rate is the number of breaths taken per minute. Like heart rate, the normal respiratory rate decreases with increasing age, and the normal respiratory rate for an adult is 10-20 breaths per minute. Increased respiratory rate may be due to exercise, anxiety, cardiac diseases, pulmonary diseases, or pain.
Respiration rate is typically measured manually by counting breaths per minute.
Temperature
Temperature is less commonly taken by occupational therapists. Normal resting temperature is 98.6°F (37°C). Temperature is generally lower in the morning and higher in the afternoon to evening. In addition, vigorous exercise can cause temperature to increase. A temperature of roughly 100°F (37.8°C) or higher is the common classification of a fever. Causes of fever may include viral or bacterial infections, heat exhaustion or severe sunburn, inflammation, neurological disorders, or medications.
Temperature can be measured using either a manual thermometer or digital thermometer.
References and Further Reading:
American Heart Association. (2015). Tachycardia: Fast heart rate. Retrieved January 4, 2016 from: heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/Tachycardia-Fast-Heart-Rate_UCM_302018_Article.jsp#.Vorli5WSypo
Krajnik, S. (2013). Occupational therapy and vital signs [Handout].
Mayo Clinic. (2015). Fever: First aid. Retrieved January 4, 2016 from: mayoclinic.org/first-aid/first-aid-fever/basics/art-20056685
Mayo Clinic. (2014a). Fever: Causes. Retrieved January 4, 2016 from: mayoclinic.org/diseases-conditions/fever/basics/causes/con-20019229
Mayo Clinic. (2014b). Tachycardia: Causes. Retrieved January 4, 2016 from: mayoclinic.org/diseases-conditions/tachycardia/basics/causes/con-20043012
Medline Plus. (2020). Hyperventilation. Retrieved September 1, 2020 from: medlineplus.gov/ency/article/003071.htm