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This article is about vital signs in medicine. For other uses of the term, see Vital signs (disambiguation).

Vital signs are often taken by health professionals in order to assess the most basic body functions. Vital signs are an essential part of a case presentation.

Contents 1 Primary four 2 Additional signs 2.1 Fifth sign 2.2 Sixth sign 3 Variations by age 4 See also 5 References 6 External links

There are four vital signs which are standard in most medical settings:

1. Body Temperature
2. Pulse rate (or heart rate)
3. Blood pressure
4. Respiratory rate

The equipment needed is a thermometer, a sphygmomanometer, and a watch.

Though a pulse can often be taken by hand, a stethoscope may be required for a patient with a very weak pulse.

The phrase "fifth vital sign" usually refers to pain, as perceived by the patient on a Pain scale of 0-10. For example, the Veterans Administration made this their policy in 1999. However, some doctors have noted that pain is actually a subjective symptom, not an objective sign, and therefore object to this classification.^[1]

Other sources include pulse oximetry as their fifth sign.^[2][3][4]

Some sources consider pupil size, equality, and reactivity to light to be a vital sign as well.^[5]

There is no standard "sixth vital sign", and the use is much more informal and discipline-dependent than with the above, but some proposals (excluding the fifth sign candidates above) include:

Children and infants have respiratory and heart rates that are faster than those of adults as shown in the following table:

Age	Normal heart rate (beats per minute)[12]	Normal respiratory rate (breaths per minute)[13]
Newborn	200-260	30-50
0-5 months	90-190	25-40
6-12 months	80-140	20-30
1-3 years	80-130	20-30
3-5 years	80-120	20-30
6-10 years	70-110	15-30
11-14 years	60-105	12-20
14+ years	60-100	12-20

• Biotelemetry

1. ^ Harold S. Lee. November 2004. Physical Diagnosis 101: A Lesson From the First Year of Medical School, in Letters to the Editor. American Society of Anesthesiologists, Volume 68, Number 11.
2. ^ Mower W, Myers G, Nicklin E, Kearin K, Baraff L, Sachs C (1998). "Pulse oximetry as a fifth vital sign in emergency geriatric assessment". Acad Emerg Med 5 (9): 858-65. PMID 9754497. 
3. ^ Mower W, Sachs C, Nicklin E, Baraff L (1997). "Pulse oximetry as a fifth pediatric vital sign". Pediatrics 99 (5): 681-6. PMID 9113944. 
4. ^ Neff T (1988). "Routine oximetry. A fifth vital sign?". Chest 94 (2): 227. PMID 3396392. 
5. ^ Daniel Limmer and Michael F. O'Keefe. 2005. Emergency Care 10th ed. Edward T. Dickinson, Ed. Pearson, Prentice Hall. Upper Saddle River, New Jersey. Page 212 and 218.
6. ^ Joseph A (2003). "Continence: the sixth vital sign?". Am J Nurs 103 (7): 11. PMID 12865635. 
7. ^ Vardi A, Levin I, Paret G, Barzilay Z (2000). "The sixth vital sign: end-tidal CO2 in pediatric trauma patients during transport". Harefuah 139 (3-4): 85-7, 168. PMID 10979461. 
8. ^ Bultz B, Carlson L (2006). "Emotional distress: the sixth vital sign--future directions in cancer care". Psychooncology 15 (2): 93-5. PMID 16444764.  link
9. ^ http://www.ohsu.edu/medicine/residency/handouts/0405handouts/COPD091304.ppt
10. ^ http://www.medicine.uiowa.edu/cme/about/documents/PrintHandout.ppt
11. ^ Bierman A (2001). "Functional status: the sixth vital sign". J Gen Intern Med 16 (11): 785-6. PMID 11722694.  link
12. ^ Emergency Care, Page 214
13. ^ Emergency Care, Page 215

• JBI