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Making sense of vital signs
  1. Bruce P Armstrong1,
  2. Michael Clancy2,
  3. Howard Simpson1
  1. 1
    Emergency Department, Basingstoke & North Hampshire Foundation Trust, Basingstoke, UK
  2. 2
    Emergency Department, Southampton University Hospital Trust, Southampton, UK
  1. Mr B Armstrong, Department of Emergency Medicine, Basingstoke & North Hampshire Foundation Hospital, Basingstoke RG24 9NA, UK; bruce.armstrong{at}bnhft.nhs.uk

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The vital signs of respiratory rate, pulse oximetry, heart rate, blood pressure, level of consciousness (Glasgow Coma Scale, GCS) and temperature are recorded because, if abnormal, they indicate that a patient has deranged physiology. This derangement may be indicative of a disease process with the risks of morbidity and mortality. To be of value, these observations need to be made on the correct population and repeated at a frequency that will provide useful information on the progression of the disease. Much time and effort is expended within nurse training and practice to obtain vital signs, yet there is no nationally agreed standard for this common nursing activity within the emergency department. We need to agree on the patients in whom vital signs should be measured, which vital signs, how often and, importantly, what should be done with that information. It should be emphasised that the measurement of vital signs complements all the other senses involved in patient assessment rather than replaces them. What follows are a series of proposed standards which, if agreed and implemented, could establish the value of such observations.

PROPOSALS FOR DISCUSSION

There are four areas which we would …

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