Vital signs help doctors diagnose illness, calculate drug dosages, and predict the risk of chronic disease. As a medical assistant, you’ll do your part to keep patients fit by taking these critical measurements before each visit. A simple but technical task requiring sound clinical judgment and good interpersonal skills, accurate readings are critical. They tell an important story about a patient’s health.
What Vital Signs Does a Medical Assistant Take?
Medical assistants take up to seven vital signs, four conventional and three secondary. Temperature, pulse, blood pressure and respiratory rate are the standard vital signs in most medical offices. However, more doctors are now asking for peripheral oxygen saturation readings, while height and weight have added significance in some specialty practices.
Which vital signs you’ll take regularly depends on where you work, it’s up to the clinical management team to set the protocols. You’ll also rely on your clinical expertise to determine if more are needed. Vocational school programs cover how to take vital signs in depth.
What Are the Steps for Taking Vital Signs?
There are a few important steps to taking vitals signs. Here are these steps in action:
Temperature
Body temperature changes in response to several factors, including exposure to heat or cold, infections, exhaustion, organ failure, and hormonal imbalances. Normal readings average 98.6 °F for adults and 97.5 °F for children with a wide range of healthy readings.
One reason vital signs are taken even at well visits is to establish the individual’s baseline. A swing of two degrees above or below the patient’s average temperature signals a health problem.
Temperature can be measured in six different ways as follows:
Orally – Oral temperatures are taken by mouth.
Steps include:
- Ensure the patient has had nothing to each or drink for two minutes before the reading.
- Place a sanitary cover over the digital thermometer probe.
- Insert the end under the patient’s tongue, begin the reading and ask them to seal their lips until it’s complete, it can take up to two minutes.
- Discard the used probe cover.
- Record the results.
Temporally – Temporal thermometers use infrared light to measure warmth over the artery at the temple.
Just:
- Turn the unit on.
- Point the thermometer at the patient’s temple from the distance recommended by the manufacturer.
- Press the “read” button.
- Record the result.
Tympanically (aurally) – Tympanic thermometers use light to measure the temperature of the eardrum:
You will:
- Place a clean cover over the ear probe.
- Insert it into the ear canal while tugging the pinna to ensure a tight fit.
- Record the reading.
Be on guard for low temperatures when you expect a fever. Scar tissue from infections can produce artificially low readings.
Axillary – Axillary temperature is taken in the axilla using an oral thermometer and these steps:
- Put a protective cover over the probe.
- Place the end into the patient’s armpit with their arm by their side.
- Record the reading, it takes up to 5 minutes.
- Record the result.
- Discard the used probe cover.
Rectally – Rectal temperature is measured with a probe in the anus.
Steps include:
- Position the patient safely.
- Cover the probe, and coat it with water-based lubricant.
- Carefully insert 1 inch of the probe into the rectum.
- Take the reading and record the results.
- Use a wipe to clean excess lubricant off the patient’s skin.
- Discard the disposable cover.
How body temperature is taken matters. Medical assistants need to know which methods are appropriate for which patients and why. Temporal temperature checks have largely replaced other methods because they’re contact-free. The results, however, can be inaccurate, so if an illness is suspected, doctors may request an oral reading.
Rectal readings are the most accurate, but they’re rarely done in office settings because they’re intrusive and risky. A slip of the hand can perforate delicate rectal tissue.
Before taking a temperature, medical assistants should review the patient’s baseline. A reading of 99.0°F, for example, is more indicative of illness in a child with an average temperature of 97.0 °F than an adult with a 98.7 °F average.
Significantly abnormal readings should be confirmed. A temperature of 105°F without obvious symptoms is likely the result of faulty equipment.
Pulse (Heart Rate)
Pulse, or heart rate, is taken by counting the pulsations in the palpable arteries near the wrist, neck, or groin. The most accessible site is the radial artery above the wrist.
The procedure is simple:
- Locate the pulsations using your first and second fingers.
- Count the pulses for 15 seconds.
- Multiply the result by four to get a 60-second reading.
- Record the results, including your observations about the pulse’s strength and regularity.
Healthy adults have pulses between 60-100. Conditioned athletes may have a slower rate, 50-60, while deconditioned persons may have tachycardia, a pulse over 100, with minor exertions.
If the heart rate is unexpectedly high, low, or irregular, retake it for a full minute. Doctors may request an apical pulse taken with a stethoscope for patients with known heart arrhythmias.
Results that seem unusual based on the patient’s history should be confirmed. And don’t measure heart rate using your thumb, the pulse you’ll feel is your own.
Respiratory Rate
Taking respiratory rate is straightforward but tricky.
- Count inhalations for 30 seconds.
- Multiply the result by two for a 1-minute reading.
- Record the result.
The normal rate is 12-20 breaths per minute. However, anxiety can cause involuntary changes in breathing patterns, leading to erroneous results if patients are aware you’re counting.
Blood Pressure
Blood pressure (BP) is the force of blood pushing against vessel walls. Noted as the systolic pressure when the heart beats over the diastolic pressure when the heart is resting, reading below 110/70 or above 140/90 are concerning.
Medical assistants take BP with a digital blood pressure machine or a stethoscope and a sphygmomanometer. The manual method is typically more accurate, but the steps are similar:
- Seat the patient in a comfortable chair.
- Position the arm at heart level.
- Wrap the blood pressure cuff around the patient’s arm, select the size most appropriate for their weight. Digital meters inflate automatically. Manual cuffs should be inflated to at least 180 mm Hg or higher in patients with hypertension.
- Electronic blood pressure machines display the reading as the cuff deflates. If you’re taking a manual BP, you’ll position your stethoscope at the elbow fold and listen for heart sounds while releasing air from the cuff using a valve.
- Record the results.
In all cases, it’s essential to screen patients for contraindications before taking a BP. If someone has a dialysis shunt in their arm, for example, you may need to take blood pressure at the wrist instead of the upper arm.
Unusually high or low readings should be rechecked but wait at least 5 minutes. Reinflating the cuff too soon can cause abnormal results.
Height
Adults lose height gradually after the age of 30. At first, it’s slow. But faster changes can indicate a progressive disease, such as osteoporosis.
You’ll measure height by:
- Asking the patient to stand straight against a vertical wall ruler.
- Lowering the attached slide rule until it touches the top of their head.
- Recording the results in inches or centimeters for easy conversion.
It’s that simple, but height should be measured the same way each time for consistency. If the patient removed their shoes the first time they were measured, they should be barefoot for each subsequent measurement.
Weight
Weight should be measured using the same scale and the same technique every time. Gaining as little as two pounds can be a risk for heart failure patients, so accuracy is crucial.
There are two simple steps:
- Ask the patient to step on the scale and stay still without holding on to grab bars or walls.
- Record the weight in pounds or kilograms and help the patient step down.
Patients with limited mobility may require a platform or wheelchair scale.
Peripheral Oxygen Saturation
Peripheral oxygen saturation (SpO2) is an estimate of blood oxygen content. Taken with an electronic fingertip pulse oximeter, readings above 92% are generally considered normal. Patients with COPD may have lower readings, while most healthy individuals average 96% or higher.
Measuring oxygen saturation is as easy as placing the meter firmly on the patient’s first or second finger and recording the reading. If it’s unusually low, and the patient has no shortness of breath, warm the digit, cold constricts peripheral blood vessels. You can also replace the batteries in your meter and try again to rule out equipment failure.
Final Thoughts
With help from licensed healthcare providers, medical assistants should use their clinical judgment to choose how they’ll obtain vital signs and which equipment they’ll use; these steps are only guidelines. A vocational school program will give you the knowledge and skills you need to take vital signs.
Want to Learn More?
The Medical Assistant program at Hunter Business School prepares competent, entry-level medical assistants in the cognitive (knowledge), psychomotor (skills), and affective (behavior) learning domains required for professional practice. The Medical Assistant program provides hands-on experience in a real medical setting where you can foster professional relationships with actual patients. Medical Assistant students spend 160 hours in an externship in an actual medical environment where they are supervised and taught in order to gain valuable on-the-job training.
The Medical Assistant training program is accredited by the Commission on Accreditation of Allied Health Education Programs, 9355 – 113th St. N, #7709 Seminole, FL 33775 upon the recommendation of the Medical Assisting Education Review Board (MAERB).
Contact us today to find out more about how to become a medical assistant on Long Island.