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Medical Assistants: Taking the 6 Vital Signs

As a medical assistant working in a doctor's office or clinic, you will likely be required to take patient vital signs. Whether you're dealing with a new patient or a familiar one, you'll be responsible for performing basic tests that establish that patient's current health. Getting accurate numbers is a critical first step in providing quality patient care, something you will learn through the proper training.

There are usually six tests you'll run at the start of every patient visit. They are:

  1. Weight
  2. Temperature
  3. Pulse
  4. Blood Pressure
  5. Respiration
  6. Pain

All of these tests are simple and non-invasive, but you need to perform them properly if you're going to get authentic results. The results of many of these tests -- particularly pulse, respiration and blood pressure -- depend largely on the patient's state of mind. If a patient feels nervous, threatened or fearful, the anxiety can trigger short-term physiological responses that may indicate underlying problems that aren't really there. In fact, there's a term for this -- "White Coat Syndrome" -- which is something you want to minimize.

Here is how to take the six patient vital signs and get the most accurate results:

1. Weight. Weight -- and weight change -- is one of the key indicators of a person's health. If a person is significantly overweight or underweight, it can signal underlying disease. This is likewise for any significant change in weight in the recent past, particularly if that change was not intended (e.g., not the result of diet and exercise). When taking a patient's weight, be sure to be matter-of-fact and non-judgmental. Many people are self-conscious about their weight, and any indication of judgment, even if it's just in your facial expression, vocal tone or body language, can be taken as threatening or even offensive. Leave discussions of weight up to the doctor.

2. Temperature. You will likely take the patient's temperature using an ear thermometer. The reading may take several seconds to register. Take the time to talk calmly to the patient and assess her/her orientation. If the patient seems agitated, confused or unresponsive, this should be noted on his/her record.

3. Pulse. You can take the pulse by placing a stethoscope over the left side of the patient's chest or by placing your thumb and index finger on the patient's wrist. You'll count the number of beats for 30 seconds. Make note of any extra or skipped beats you detect during that period. After 30 seconds, double the final number to determine the number of beats per minute.

4. Blood Pressure. Carefully wrap your blood pressure cuff around the patient's upper arm. Place the stethoscope's ear tips in both ears, and the diaphragm on the brachial artery at the base of the inner elbow. Inflate the blood pressure cuff to 200 mg., then slowly release the valve. Listen for the telltale pulse. When you hear this, note the number on the meter. This is the systolic pressure. When the pulse disappears, note that number as well. That's the diastolic pressure.

5. Respiration. The 30 seconds or so it takes to wrap the blood pressure cuff on the patient's arm is a good time to observe his/her respiration. Count the number of breaths taken over the half-minute period, and be mindful of any obvious breathing problems, such as coughing or shortness of breath. Because respiration can be controlled voluntarily, it's important not to tell patients what you're doing because they're apt to alter their breathing in response, even subconsciously.

6. Pain. Finally, ask the patient if they're in any immediate pain. If the answer is yes, ask them to rate that pain on a scale of one to 10, with 10 being unbearable. Make a note about both the site of the pain and its intensity for the doctor's review.

Taking vital signs is a critical first step in patient evaluation. In all cases, you need to perform these tests in a warm, comforting but ultimately dispassionate manner. No matter what the readings are, you don't want to appear alarmed or even particularly approving. Your job is to gather information, not make judgments, whether positive or negative. Do your job properly and your supervising physician will have the data he/she needs to better determine the patient's health, if further tests need to be run, and what course of action, if any, is recommended to deliver proper care.

 


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