Vital SignsDono Indarto,dr., MBiotechSt.AIFM

PendahuluanDefinisi: pengukuran suhu, frekuensi pernapasan, denyut nadi dan tekanan darah.Informasi penting status kesehatan penderita.Namun tanda-tanda vital dbn tidak menjamin status fisiologisnya juga dbn.Lebih tepat sebagai observasi klinik yg diikuti pmx lain= status klinis penderita.

Pengukuran suhuAda 3 tempat yang umum dilakukan: sublingual, aksilla dan rektal.Sublingual: sakus sublingual posterior sinistra atau dekstra.Hasil akurat 15-20 menit setelah makan dan minum.6 menit pembacaan untuk membedakan febris dan afebris.

Tabel 1. Pengukuran suhu

The different body areas that have been used for the measurement of body temperature include: A wide range of instruments have been used to measure these temperatures, and include: mouth axilla tympanic membrane rectum skin surface pulmonary artery nose groin oesophagus trachea urinary bladder urine glass mercury thermometer electronic thermometer pulmonary artery catheter endotracheal tube with temperature probe urinary catheter with temperature probe liquid crystal thermometer strip disposable thermometers infrared (tympanic) thermometers

Pengukuran suhu (cont)Peraksilla: hasil bervariasi antar individu.Rectal temperatures, which most closely reflect internal or core values, are approximately 1 degree F higher than those obtained orally. Temperature is measured in either Celcius or Farenheit, with a fever defined as greater than 38-38.5 C or 101-101.5 F.

Frekuensi pernapasanRespirations are recorded as breaths per minute.They should be counted for at least 30 seconds as the total number of breaths.This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 12 and 20.It can be a very reliable marker of disease activity in the setting of cardio-pulmonary illness.

Denyut nadiThis can be measured at any place where there is a large artery (e.g. carotid, femoral, or simply by listening over the heart), though for the sake of convenience it is generally done by palpating the radial impulse.Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel. You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements.

Tekanan darahBlood pressure (BP) is measured using mercury based manometers, with readings reported in millimeters of mercury (mm Hg). The inflatable bladder, which can be felt through the vinyl covering of the cuff, should reach roughly 80% around the circumference of the arm while its width should cover roughly 40%. If it is too small, the readings will be artificially elevated. The opposite occurs if the cuff is too large.

Korotkoff's SoundsMeasurement of blood pressure by auscultation is based on the sounds produced as a result of changes in blood flow, termed Korotkoff's sounds, and are:1. Phase I The pressure level at which the first faint, clear tapping sounds are heard, which increase as the cuff is deflated (reference point for systolic BP).2. Phase II During cuff deflation when a murmur or swishing sounds are heard.3. Phase III The period during which sounds are crisper and increase in intensity.4. Phase IV When a distinct, abrupt, muffling of sound is heard5. Phase V The pressure level when the last sound is heard (reference point for diastolic BP).

Recommended Blood Pressure Measurement TechniquePatient should be seated and have rested for 5 minutes and have arm supported at heart level. Appropriate cuff size should be used, and the bladder should nearly (at least 80%) or completely encircle arm. Patients should not have smoked or ingested caffeine within 30 minutes before measurements. Measurements should be taken with a mercury sphygmomanometer, a recently calibrated aneroid manometer, or a calibrated electronic device. Both systolic and diastolic blood pressure should be recorded. Korotkoff's phase V (disappearance of sound) should be used for the diastolic reading. Two or more readings, separated by 2 minutes, should be averaged, and more taken if they differ by more than 5mmHg.