Taking a pulse (heart rate)

Your pulse is the rate at which your heart beats. As your heart pumps blood through
your body, you can feel a pulsing in some of the blood vessels close to the skin's
surface.

The usual resting pulse for an adult is 60 to 100 beats per minute. Certain illnesses
can cause your pulse to change, so it is helpful to know what your resting pulse is
when you are well. To find your resting pulse, count your pulse after you have been
sitting or resting quietly for at least 10 minutes.

You can easily check your pulse on the inside of your wrist, below your thumb.

• Gently place 2 fingers of your other hand on this artery.

• Do not use your thumb because it has its own pulse that you may feel.
• Count the beats for 30 seconds; then double the result to get the number of
beats per minute.

You can also check your pulse in the carotid artery. This is located in your neck, on
either side of your windpipe. Be careful when checking your pulse in this location,
especially if you are older than 65. If you press too hard, you may become
lightheaded and fall.
 Your Pulse and Your Target Heart Rate
What is your pulse?
Your pulse is your heart rate, or the number of times your heart beats in one minute.
Pulse rates vary from person to person. Your pulse is lower when you are at rest and
increases when you exercise (because more oxygen-rich blood is needed by the body
when you exercise).

Knowing how to take your pulse can help you evaluate your exercise program.

How to take your pulse

1. Place the tips of your index, second, and third fingers on the palm side of your
other wrist, below the base of the thumb. Or, place the tips of your index and second
fingers on your lower neck, on either side of your windpipe. (See the illustrations to
the right.)

2. Press lightly with your fingers until you feel the blood pulsing beneath your
fingers. You might need to move your fingers around slightly up or down until you
feel the pulsing.

3. Use a watch with a second hand, or look at a clock with a second hand.

4. Count the beats you feel for 10 seconds. Multiply this number by six to get your
heart rate (pulse) per minute.
Check your pulse: _______________ x 6 = ________________
(beats in 10 seconds) (your pulse)

What is a normal pulse?

Age Group Normal Heart Rate at Rest

Children (ages 6-15) 70-100 beats per minute
Adults (age 18 and over) 60-100 beats per minute

Rr=Normal findings

Average respiratory rate reported in a healthy adult at rest is usually given as 12

breaths per minute (12⁄60 Hz)[1][2] but estimates do vary between sources, e.g., 12–20
breaths per minute, 10–14,[3] between 16–18,[4] etc. With such a slow rate, more
accurate readings are obtained by counting the number of breaths over a full minute.

[edit] Optimum breathing

A trained, systematic approach to deep breathing may lower respiration rates in

cardiac patients, helping them to maintain healthy blood oxygen levels and become
more physically fit. In one study, 15 cardiac patients were assigned to one of two
experimental groups. One of the groups learned "complete yoga breathing," a style of
respiration that encourages slow, deep breathing at a rate of about six breaths per
minute. Those patients continued practicing the breathing method at home for an hour
a day. After a month, the patients practicing the breathing technique breathed more
slowly, had higher levels of blood oxygen, and performed better on exercise tests.[5]

Average respiratory rates, by age:

• Newborns: Average 44 breaths per minute

• Infants: 20–40 breaths per minute
• Preschool children: 20–30 breaths per minute
• Older children: 16–25 breaths per minute
• Adults: 12–20 breaths per minute
• Adults during strenuous exercise 35–45 breaths per minute
• Athletes' peak 60–70 breaths per minute[6]

Examples

• 5-year-old child sitting (Breathing frequency: 23⁄60 Hz, Tidal volume: 0.213 L)

• Adult male sitting (Breathing frequency: 12⁄60 Hz, Tidal volume: 0.75 L)[7]
Respiratory Rate
WHAT YOU SHOULD KNOW
Your respiratory rate is measured in number of breaths per minute. For most
people it's typically 12 to 20. The rate increases during exercise, excitement, pain,
and fever. It declines during relaxation and sleep. Your doctor may want regular
readings of your respiratory rate if you have a lung disease or other illness, or are
taking a medicine that can suppress respiration. Often, readings are needed
before and after exercise.

WHAT YOU SHOULD DO

Mere awareness of your breathing is enough to change your respiratory rate, so
taking your own count is not recommended. For a more accurate measurement,
have someone else take the reading.

To Count Respirations

You'll need a watch or clock with a second hand. Keep count for a full 60 seconds.
(If you wish, you may count for 30 seconds and multiply the number by 2.) The
person should be seated. Place your hand on the upper chest to feel it rise and
fall. Each rise/fall cycle counts as one respiration. Note whether the individual's
breathing is deep (slow) or shallow (fast). Write down anything else you notice
about the breathing (for example, regularity or irregularity).
How to Measure and Record Respiratory Rate
By eHow Health Editor
Rate: (32 Ratings)

An injured person's respiratory rate will help the rescuer assess the injury, and is an
important indicator of how the person is responding to treatment. Record the
respiratory rate every 15 minutes and pass this information on to a medical
professional when care is transferred.

Instructions

Things You'll Need:

• Notebooks
• Pens
• Stopwatches
• Pens
• Notebooks

1. Step 1

Observe the injured person's stomach or chest and watch until you see it rise
and fall.

2. Step 2
 Count the number of times the stomach or chest rises for 15 seconds and
multiply by 4, or for 30 seconds and multiply by 2. This tells you the
respiratory rate per minute.

3. Step 3

Note the rhythm of the breathing. Is it regular or irregular?

4. Step 4

Note how much effort it takes for the person to breathe. Is the breath labored,
or effortless?

5. Step 5

Note if the breathing is deep or shallow.

6. Step 6

Smell the breath for any unusual odor, especially noting a fruity odor or a fecal
odor.

7. Step 7

Record your findings in the following manner: rate, rhythm, effort, depth,
noise and odors. For example: "Respiratory rate is 30, irregular, labored,
shallow, gurgling and with no odor."

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Non-Traumatic Emergencies

Vital Signs (Body Temperature, Pulse Rate, Respiration Rate,

Blood Pressure)

What are vital signs?

Vital signs are measurements of the body's most basic functions. The four main vital
signs routinely monitored by medical professionals and healthcare providers include
the following:

• body temperature
• pulse rate
• respiration rate (rate of breathing)
• blood pressure (Blood pressure is not considered a vital sign, but is often
measured along with the vital signs.)

Vital signs are useful in detecting or monitoring medical problems. Vital signs can be
measured in a medical setting, at home, at the site of a medical emergency, or
elsewhere.

What is body temperature?

The normal body temperature of a person varies depending on gender, recent activity,
food and fluid consumption, time of day, and, in women, the stage of the menstrual
cycle. Normal body temperature, according to the American Medical Association, can
range from 97.8° F (or Fahrenheit, equivalent to 36.5° C, or Celsius) to 99° F (37.2°
C). A person's body temperature can be taken in any of the following ways:

What is fever?

Fever (also called pyrexia) is defined as body temperature that is higher than normal
for each individual. It generally indicates that there is an abnormal process going on
within the body. The severity of a condition is not necessarily reflected by the degree
of fever. For example, influenza may cause a fever of 104° F, while pneumonia may
cause a very low-grade fever or no fever at all. Consult with your physician if you
have any questions about whether a fever is significant.

• orally
Temperature can be taken by mouth using either the classic glass thermometer,
or the more modern digital thermometers that use an electronic probe to
measure body temperature.
• rectally
Temperatures taken rectally (using a glass or digital thermometer) tend to be
0.5 to 0.7° F higher than when taken by mouth.
• axillary
Temperatures can be taken under the arm using a glass or digital thermometer.
Temperatures taken by this route tend to be 0.3 to 0.4° F lower than those
temperatures taken by mouth.
 • by ear
A special thermometer can quickly measure the temperature of the ear drum,
which reflects the body's core temperature (the temperature of the internal
organs).

Body temperature may be abnormal due to fever (high temperature) or hypothermia

(low temperature). A fever is indicated when body temperature rises above 98.6° F
orally or 99.8° F rectally, according to the American Medical Association.
Hypothermia is defined as a drop in body temperature below 95° F.

About glass thermometers containing mercury:

According to the Environmental Protection Agency (EPA), mercury is a toxic

substance that poses a threat to the health of humans, as well as to the environment.
Because of the risk of breaking, glass thermometers containing mercury should be
removed from use and disposed of properly in accordance with local, state, and
federal laws. Contact your local health department, waste disposal authority, or fire
department for information on how to properly dispose of mercury thermometers.

What is the pulse rate?

The pulse rate is a measurement of the heart rate, or the number of times the heart
beats per minute. As the heart pushes blood through the arteries, the arteries expand
and contract with the flow of the blood. Taking a pulse not only measures the heart
rate, but also can indicate the following:

• heart rhythm
• strength of the pulse

The normal pulse for healthy adults ranges from 60 to 100 beats per minute. The pulse
rate may fluctuate and increase with exercise, illness, injury, and emotions. Females
ages 12 and older, in general, tend to have faster heart rates than do males. Athletes,
such as runners, who do a lot of cardiovascular conditioning, may have heart rates
near 40 beats per minute and experience no problems.

Click Image to Enlarge

How to check your pulse:

As the heart forces blood through the arteries, you feel the beats by firmly pressing on
the arteries, which are located close to the surface of the skin at certain points of the
body. The pulse can be found on the side of the lower neck, on the inside of the elbow,
or at the wrist. When taking your pulse:

• Using the first and second fingertips, press firmly but gently on the arteries
until you feel a pulse.
• Begin counting the pulse when the clock's second hand is on the 12.
• Count your pulse for 60 seconds (or for 15 seconds and then multiply by four
to calculate beats per minute).
• When counting, do not watch the clock continuously, but concentrate on the
beats of the pulse.
• If unsure about your results, ask another person to count for you.

If your physician has ordered you to check your own pulse and you are having
difficulty finding it, consult your physician or nurse for additional instruction.

What is the respiration rate?

The respiration rate is the number of breaths a person takes per minute. The rate is
usually measured when a person is at rest and simply involves counting the number of
breaths for one minute by counting how many times the chest rises. Respiration rates
may increase with fever, illness, and with other medical conditions. When checking
respiration, it is important to also note whether a person has any difficulty breathing.

Normal respiration rates for an adult person at rest range from 15 to 20 breaths per
minute. Respiration rates over 25 breaths per minute or under 12 breaths per minute
(when at rest) may be considered abnormal.

What is blood pressure?

Blood pressure, measured with a blood pressure cuff and stethoscope by a nurse or
other healthcare provider, is the force of the blood pushing against the artery walls.
Each time the heart beats, it pumps blood into the arteries, resulting in the highest
blood pressure as the heart contracts. One cannot take his/her own blood pressure
unless an electronic blood pressure monitoring device is used. Electronic blood
pressure monitors may also measure the heart rate, or pulse.

Two numbers are recorded when measuring blood pressure. The higher number, or
systolic pressure, refers to the pressure inside the artery when the heart contracts and
pumps blood through the body. The lower number, or diastolic pressure, refers to the
pressure inside the artery when the heart is at rest and is filling with blood. Both the
systolic and diastolic pressures are recorded as "mm Hg" (millimeters of mercury).
This recording represents how high the mercury column is raised by the pressure of
the blood.
High blood pressure, or hypertension, directly increases the risk of coronary heart
disease (heart attack) and stroke (brain attack). With high blood pressure, the arteries
may have an increased resistance against the flow of blood, causing the heart to pump
harder to circulate the blood.

According to the National Heart, Lung, and Blood Institute (NHLBI) of the National
Institutes of Health (NIH), high blood pressure for adults is defined as:

• 140 mm Hg or greater systolic pressure

and
• 90 mm Hg or greater diastolic pressure

In an update of NHLBI guidelines for hypertension in 2003, a new blood pressure

category was added called prehypertension:

• 120 mm Hg – 139 mm Hg systolic pressure

and
• 80 mm Hg – 89 mm Hg diastolic pressure

The new NHLBI guidelines now define normal blood pressure as follows:

• Less than 120 mm Hg systolic pressure

and
• Less than 80 mm Hg diastolic pressure

These numbers should be used as a guide only. A single elevated blood pressure
measurement is not necessarily an indication of a problem. Your physician will want
to see multiple blood pressure measurements over several days or weeks before
making a diagnosis of hypertension (high blood pressure) and initiating treatment. A
person who normally runs a lower-than-usual blood pressure may be considered
hypertensive with lower blood pressure measurements than 140/90.

Why should I monitor my blood pressure at home?

For persons with hypertension, home monitoring allows your physician to monitor
how much your blood pressure changes during the day, and from day to day. This may
also help your physician determine how effectively your blood pressure medication is
working.

What special equipment is needed to measure blood pressure?

Either an aneroid monitor, which has a dial gauge and is read by looking at a pointer,
or a digital monitor, in which the blood pressure reading flashes on a small screen, can
be used to measure blood pressure.

About the aneroid monitor:

The aneroid monitor is less expensive and easier to manage than the digital monitor.
The cuff is inflated by hand by squeezing a rubber bulb. Some units even have a
special feature to make it easier to put the cuff on with one hand. However, the unit
can be easily damaged and become less accurate. Because the person using it must
listen for heartbeats with the stethoscope, it may not be appropriate for the hearing-
impaired.

About the digital monitor:

The digital monitor is automatic, with the measurements appearing on a small screen.
Because the recordings are easy to read, this is the most popular blood pressure
measuring device. It is also easier to use than the aneroid unit, and since there is no
need to listen to heartbeats through the stethoscope, this is a good device for hearing-
impaired patients. One disadvantage is that body movements or an irregular heart rate
can change the accuracy. These units are also more expensive than the aneroid
monitors.

About finger/wrist blood pressure monitors:

Tests have shown that finger and/or wrist blood pressure devices are not as accurate in
measuring blood pressure as other types of monitors. In addition, they are more
expensive than the other monitors.

Before you measure your blood pressure:

• Rest for three to five minutes without talking before taking a measurement.
• Sit in a comfortable chair, with your back supported and your legs and ankles
uncrossed.
• Sit still and place your arm, raised level with your heart, on a table or hard
surface.
• Wrap the cuff smoothly and snugly around the upper part of your arm. The
cuff should be sized to fit smoothly, while still allowing enough room for one
fingertip to slip under it.
• Be sure the bottom edge of the cuff is at least one inch above the crease in
your elbow.

It is also important, when taking blood pressure readings, that you record the date and
time of day you are taking the reading, as well as the systolic and diastolic
measurements. This will be important information for your physician to have. Ask
your physician or another healthcare professional to teach you how to use your blood
pressure monitor correctly. Have the monitor routinely checked for accuracy by taking
it with you to your physician's office. It is also important to make sure the tubing is
not twisted when you store it and keep it away from heat, to prevent cracks and leaks.

Proper use of your blood pressure monitor will help you and your physician in
monitoring your blood pressure.

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[Edit]
What is the normal range of respiratory rate of less
than 1 year old?
In: Respiratory Rate [Edit categories]

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30-40 breaths per minute

Average respiratory range by age is given below:

• Newborns – Average 44 breaths per minute

• Infants – 20-40 breaths per minute
• Pre school children – 20-30 breaths per minute
• Older children – 16-25 breaths per minute
• Adults – 12-20 breaths per minute
• Adults during strenuous exercise – 35-45 breaths per minute
• Athletes peak – 60-70 breaths per minute