Vital Signs

With a few tools and an eye for observation, you can help detect and monitor health problems in your family. Everyone needs to know how to take a temperature and count pulse and respiration rates. It is also good to learn how to take your own blood pressure. You may even want to learn to do simple ear exams. The tools you need are inexpensive and usually come with instructions.

Temperature

A normal temperature ranges from 97.6° to 99.6° and for most people is 98.6°. Temperature varies with time of day and other factors, so don't worry about minor changes.

Whenever a person feels hot or cold to your touch, it is a good idea to take and record his or her temperature. If you have to call your doctor during an illness, knowing the exact temperature will be very helpful.


There are four ways to take a temperature:

• Orally (in the mouth)


• Rectally (in the anus)


• Axillary (under the armpit)


• Using an electronic oral or ear thermometer or temperature strip

Unless otherwise specified, all temperatures in this site are oral Fahrenheit readings. If you take a rectal or axillary temperature, adjust it accordingly. Rectal temperatures are the most accurate.

Oral temperatures are recommended for adults and children age six years and
older.

• Clean the thermometer with soapy water or rubbing alcohol.


• Hold it firmly at the end opposite the bulb and shake the mercury down to 95° or lower.


• Do not drink hot or cold liquids beforehand.


• Place the bulb under the tongue and close the lips around it. Do not bite it. Breathe through the nose and do not talk.


• Wait three to five minutes.

Rectal temperatures are recommended for children younger than six years or anyone who cannot hold an oral thermometer in the mouth. Use only a rectal thermometer. Rectal temperature is 0.5° to 1° higher than oral temperature.

• Clean the thermometer and shake it down (see above).


• Put Vaseline or another lubricant on the bulb.


• Hold the child bottom-up across your lap.


• Hold the thermometer one inch from the bulb and gently insert it into the rectum no more than one inch. Do not let go. Hold it right at the anus so that it cannot slip in farther.


• Wait for three minutes.

Axillary temperatures are less accurate and about 1° lower than oral. They are safer for small children who will not hold still while you use a rectal thermometer.

• Use either an oral or rectal thermometer. Shake it down below 95°.


• Place the thermometer in the armpit and have the child cross her arm across the chest and hold her opposite upper arm.


• Wait five minutes.

How to Read a Thermometer

• Roll the thermometer between your fingers until you can see the thin ribbon of mercury. Note that the thermometer is marked from 92° to 108°.


• Each large mark indicates one degree of temperature. Each small mark indicates 0.2°.

Electronic thermometers are convenient and easy to use. They are quite accurate, but some are expensive. Temperature strips should only be used to measure axillary (armpit) temperature. They are inaccurate when used on the forehead.

Taking a Pulse

The pulse is the rate at which your heart is beating. As the heart forces blood through your body, you can feel a throbbing in the arteries wherever they come close to the skin surface. The pulse can be taken at the wrist, neck, or upper arm.

Certain illnesses can cause the pulse to increase, so it is helpful to know what your resting pulse rate is when you are well. The pulse rate rises about 10 beats per minute for every degree of fever.

• Count the pulse after the person has been sitting or resting quietly for 5 to 10 minutes.


• Place two fingers gently against the wrist as shown (don't use your thumb).


• If it is hard to feel the pulse in the wrist, locate the carotid artery in the neck, just to either side of the windpipe. Press gently.


• Count the beats for 30 seconds, then double the result for beats per minute.

Counting Respiration Rates

Your respiration rate is how many breaths you take in a minute. It increases with fever and some illnesses. The best time to count respiration is when a person is resting, perhaps after taking the pulse while your fingers are still on his or her wrist. The person's breathing is likely to change if the person knows you are counting it.

• Count the number of times the chest rises in one full minute.


• Notice whether there is any sucking in beneath the ribs or any apparent wheezing or difficulty breathing.

Measuring Blood Pressure

Blood pressure is the force of the blood pulsing against the walls of your arteries. The pressure when the heart beats is called the systolic pressure (the first number in blood pressure readings). The pressure between beats, when the heart is at rest, is called the diastolic pressure. A blood pressure reading below 140/90 is considered normal for an adult over 18.

Most people with good hearing can learn to measure blood pressure using a stethoscope and a blood pressure cuff (sphygmomanometer). Electronic blood pressure cuffs are also available, which do not require a stethoscope or goodhearing.

• Ask your pharmacist to recommend a blood pressure kit and show you how to use it.


• Regular in-home blood pressure monitoring is recommended for anyone who has heart disease or high blood pressure.