Our response to COVID-19
How we're keeping our patients & caregivers safe

Vital Signs

January 2, 2022

Human vital signs are some of the most important and clear markers of health regardless of age. It’s even more important to closely monitor the vital signs of the elderly, especially elderly patients, because simply vital signs may be the first warning that something is wrong with the patient.

Here’s what you need to know about the most important human vital signs, how to monitor them, and how to tell when something is wrong with each measurement.

What Are Vital Signs?

Vital signs are the measurements of the human body’s most basic functions. There are four main vital signs, though one of them is less a vital sign and more something that is commonly checked along with vital signs.

Measuring vital signs is important because your vital signs are often some of the first indicators that something has gone wrong.

The Four Main Vital Signs

There are four main vital signs you should worry about when you’re checking vital signs on an elderly patient.  Those vital signs are:

●        Body Temperature

●        Pulse Rate

●        Respiration Rate (breathing rate)

●        Blood Pressure (Not a true vital sign, but typically measured at the same time)

We’ll cover each of these signs in more detail in their own sections.


What Is Body Temperature

Body temperature is one of the most important vital signs and can also be one of the first indications of a problem. Normal body temperature is between 97.8- and 99-degrees Fahrenheit, or 36.5-37.2 degrees Celsius.  Any time an elderly patient’s body temperature is outside of normal range it can be a sign of something wrong and should be taken seriously.

Body temperature can also be affected by the environment and a wide range of health conditions. Monitoring body temperature is one of the best ways to quickly check in on someone's overall health and condition and is a good way to make sure they’re doing well.

Body temperature might not be foolproof, but it's an important tool for monitoring your health as well as patient health.

However, there are multiple different ways to take body temperature, and some are more accurate and effective than others. 

Here are some of the different ways you can take body temperature:

Oral Body Temperature

Taking body temperature orally is one of the most common methods because it’s simple and quick, but it can also be a little less accurate. Most thermometers you can get at a local store are oral routes and get a relatively accurate read of your temperature just by holding them in your mouth for a couple of minutes.

However, since these thermometers aren’t the most accurate, you may want to consider other options.

Rectal Body Temperature

Rectal body temperature is one of the most accurate ways to track an elderly patient's body temperature. However, since it requires using a specially designed thermometer inserted into the anus, not all elderly patients will be comfortable with having their temperature taken this way.

In those cases, it may be a good idea to reserve rectal body temperature for serious situations or when accuracy is most important and other options aren’t available.

Auxiliary Body Temperature

Auxiliary body temperature is a little different from the other kinds of body temperature because it’s going to be a little lower than any other kind of temperature. This type of temperature is taken in the armpit, and some thermometers designed for oral or rectal use can also be used to take axillary body temperature in the armpit.

If you are taking axillary body temperature, remember that the reading will be between 1 and 2 degrees lower than it would be taken elsewhere.

Ear Body Temperature

Specially designed thermometers let you take your temperature in the ear, which is one of the easiest and least invasive ways to take an elderly patient's temperature. Like taking temperature orally it's a good idea to remember that ear body temperature is a little less accurate than taking the temperature rectally.

Skin Body Temperature

Newer thermometers are available that can read body temperature from the skin. These are typically the least invasive method of taking body temperature, but quality varies a lot depending on the manufacturer. Skin body temperature readings are usually taken on the forehead and temple, though some thermometers have other options as well.

Regardless of how you're reading body temperature, it's important to remember that a higher-than-average body temperature is a fever, and a lower-than-average body temperature is hypothermia. Both can be signs that something is wrong, and both conditions are considered more severe the further outside of the normal range the patient becomes.

If you’re uncertain about the results from one thermometer, it’s a good idea to use a second thermometer or change which body temperature reading method you’re using. That way you can get a better idea of true body temp without the uncertainty of a single reading.

What Is The Pulse Rate

The pulse rate is a measurement of how many times the heartbeats per minute. Pulse rate is important because both low and high measurements can tell you that something is wrong with the patient, and both can cause serious problems in severe cases.

Measuring the pulse rate also involves checking the strength and rhythm of the pulse. A normal human pulse rate should feel strong and have a regular beat. Anything else is a sign of trouble.

A normal human pulse rate is between 60 to 100 beats per minute. However, the pulse rate can fluctuate with exercise, illness, injury, and emotions. Usually, all of those situations will increase your pulse rate. However, there are some situations where the pulse rate will dip below normal.

It's also important to know that people with a very high fitness level may have a slower than average pulse rate. In those cases, you can reference their past pulse rates for a better idea of their baseline rate.

How To Measure Your Pulse

Measuring your pulse is relatively simple, and you can use the same method to take your own pulse as you would use to take a patient’s pulse.

First, take your first and second fingertips and press them into an artery until you feel a pulse. Firm but gentle is the rule here. The most common arteries for taking a pulse are the arteries in the neck, just under the chin, back towards your ear, or on your wrist near the thumb.

Use a clock or watch for reference, preferably a non-digital clock so you can watch the second hand. Start counting the pulse rate when the second hand is on the 12, and keep counting till it reaches 12 again. Focus more on counting the pulse than watching the seconds.

Alternatively, you can count your pulse for 15 seconds, then multiply that number by 4 to get an approximate beats-per-minute.

If you’re unsure of your results, you can consult with someone else to take your pulse and compare.

What Is Respiration Rate?

Respiration rate is a measure of how many breaths a person takes per minute. Normal respiration rates at rest are between 12 and 16 breaths per minute.

However, respiration rates can increase or decrease with fever, illness, or other medical conditions.

How To Measure Respiration Rate

The most basic way to measure a person’s respiration rate is simple. You’ll just count the number of breaths they take for one minute. Typically counting breaths is done by counting how many times their chest rises as they breathe.

If you’re unsure of a patient’s respiration you can always count for another minute to confirm your original result.

Both low and high respiration rates can be a cause for concern, and respiration rates can change rapidly. It's best to measure respiration when the person is at rest, but it's also good to pay attention to changes in respiration at other times.


What Is Blood Pressure?

Blood pressure is a measurement of the force of blood pushing against artery walls during the normal contraction and relaxation of the heart. There are two numbers measured when you check blood pressure.

The higher number, systolic pressure, refers to the pressure inside the artery when the heart contracts and pumps blood through the body. The lower number, diastolic pressure, refers to blood pressure inside the artery when the heart is at rest and filling with blood.

Hypertension is the medical term for high blood pressure and is a relatively common condition. People with high blood pressure are at increased risk of a heart attack.

Stages Of Blood Pressure

Blood pressure has several important ranges for caregivers to pay attention to.

  • Normal blood pressure is systolic of less than 120, and a diastolic of less than 80. Written blood pressure at this level would be 120/80.
  • Elevated blood pressure is a systolic measurement between 120 and 129, with diastolic less than 80.
  • Stage 1 high blood pressure is systolic between 130 and 130, or diastolic between 80 and 89.
  • Stage 2 high blood pressure is measured when systolic blood pressure is 140 or higher, and diastolic b blood pressure is 90 or higher.

Low blood pressure is less common, but can also cause problems.


How To Measure Blood Pressure

There are several different methods to measure blood pressure. As a caregiver, you should be familiar with all of them, as well as the typical precautions for taking blood pressure.

An aneroid monitor is a blood pressure cuff like the ones at most doctor's offices. An arm cuff is inflated by squeezing a rubber bulb (or by a machine). Once sufficient pressure is reached the dial gauge shows blood pressure and is read by looking at a pointer.

Digital blood pressure monitors provide blood pressure information on a small screen.

Finger and wrist monitors also show measurements on a small screen when in use. However, studies have shown that this method of measuring blood pressure is less effective than other monitors, and they can be more expensive than the alternatives.

Keeping measurement accuracy in mind is important, especially if you’re caring for a patient with stage 1 or stage 2 high blood pressure.

Measuring Blood Pressure

There are a few precautions you should take before measuring blood pressure. These precautions help make sure you’re getting an accurate measure of blood pressure rather than a measure that’s affected by unrelated conditions.

For instance, it’s important not to smoke or drink coffee (or other caffeinated beverages) for at least 30 minutes before taking your blood pressure. That’s because both nicotine and caffeine can have an effect on blood pressure and may lead to an inaccurate reading.

You should also go to the bathroom before taking your blood pressure. That’s because physical discomfort can increase blood pressure naturally, leading to an inaccurate reading.

Ideally, you should also relax for at least 5 minutes before taking blood pressure to give your body the best opportunity for an accurate resting blood pressure reading.

You should sit with your back supported, but not on an overly soft surface. A couch or soft chair isn’t usually a good option. Keep your feet on the floor and uncrossed, even at the ankle. Ideally, you should rest the arm you're reading blood pressure on a solid flat surface, like the arm of a chair or an elbow-height table.

Place the cuff of a cuff monitor just above the bend in the elbow. Refer to the monitor’s manual for more detailed placement and use information.

You should also always take multiple blood pressure readings for the best results. Take 2-3 readings, one minute apart each, and record each reading in your patient notes.

It’s also important to take your blood pressure at the same time every day, or as directed by a healthcare provider. That’s because your blood pressure naturally fluctuates through the day, so it’s important to get a similar reading each day to identify any trends in your blood pressure. Especially if you’re monitoring blood pressure for a health condition, getting consistent blood pressure data may help guide treatment options and make it easier for carers to get reliable information about your health.

If you’re uncertain about a blood pressure reading, take a few minutes to relax and then take your blood pressure again.