Vital signs are measurements of the body’s core physical functions. They give doctors important insights into a patient’s cardiovascular, respiratory, and general health. As a medical assistant, it’s your responsibility to measure vital signs at the beginning of each visit to help doctors make better clinical decisions. Taking accurate vital signs is among the most meaningful ways you will contribute to your patients’ health.
What Vital Signs Do Medical Assistants Take?
Medical assistants generally take these five vital signs:
Vital Sign #1: Temperature
The body generates its own heat, fueled in part by food consumption, hormones, activity and even the time of day. Affected by many disease processes, temperature changes usually indicate some sort of physical stress.
As a medical assistant, you will measure body temperature using one of three common methods:
Oral Temperature
Oral temperatures are accurate to a tenth of a degree if taken properly as follows:
- Screen the patient — choose an alternative method for young children who cannot follow instructions or anyone with shortness of breath who cannot keep their mouth closed for a full minute.
- Ensure the patient has had nothing to eat or drink for the last 15 minutes as hot or cold food and fluids can skew the readings.
- Wash your hands and prepare the thermometer with a disposable probe cover while you explain the procedure. Tell them the thermometer will stay securely in their mouth until they hear a beep.
- Insert the thermometer under the tongue and await the reading.
- Cleanse and store the thermometer for the next patient.
- Record the reading in the patient’s chart, flagging any abnormalities.
For most people, the normal oral temperature ranges between 97.6°F to 99.6°F (36.4°C to 37.6°C). It’s important to note, however, that normal body temperature varies and should be interpreted in the context of the patient’s usual temperature. Changes of two degrees can be clinically significant even if the reading is within the normal range.
A high temperature may indicate:
- Infection
- Hyperthyroidism
- Certain types of cancer
A low reading could suggest:
- Hypothermia
- Malnutrition
- Hypothyroidism
- Severe infection
Tympanic Temperature
Tympanic thermometers measure the temperature of the eardrum using infrared light. They are as accurate as oral thermometers when used as directed following these steps:
- Screen the patient — a tympanic temperature should not be used in patients with a sore ear, heavy earwax accumulation, or an ear infection.
- Prepare the thermometer with a fresh disposable probe cover.
- Insert the thermometer probe into the ear canal while gently pulling the earlobe upward and slightly backward to straighten the ear canal.
- Press the start button to take the reading, most thermometers require five seconds or less.
- Remove the thermometer, discard the disposable probe, and cleanse and store the thermometer.
- Readings average half a degree Fahrenheit higher than temperatures taken orally.
Temporal Temperature
Temporal thermometers rely on infrared technology to measure the temperature above the temporal artery on the side of the forehead. Some are touch-free while others require skin contact for accuracy. Each model is different, so following the manufacturer’s instructions is critical. The overall procedure is similar to taking an oral or tympanic temperature and its child friendly.
If the patient has been outdoors in very hot or cold conditions, wait 15 minutes to take the reading. Like a tympanic thermometer, results are closer to actual body temperatures but average 0.5 °F or about 0.1°C.
Vital Sign #2: Pulse
Every heartbeat produces a pulsation that felt through the skin over major arteries. The pulse is measured in the neck, groin, or foot, but the most accessible site is on the wrist just above the thumb over the radial artery.
To measure a patient’s pulse:
- Screen the patient — people with nerve or circulatory deficits in their arms may have a normal heart rate but an irregular radial pulse.
- Gently press the pads of your index and middle finger on the radial artery.
- Count the number of beats felt in 30 seconds and multiply it by two to get a 60-second reading. Notice if the pulse is strong, weak, or irregular.
- Count for a full minute if you note irregularities, documenting the strength and character of the pulse in your notes.
The normal heart rate for a healthy adult ranges from 60–100 beats per minute, but that can vary significantly with age, activity or illness. Infants may have normal pulses as high as 180 beats per minute while conditioned athletes can have healthy heart rates as low as 50.
A high heart rate, or tachycardia, may be the result of:
- Abnormalities in the heart’s electrical system
- Hyperthyroidism
- Infection and fever
- Atherosclerosis
- Low blood pressured
- Anemia
- Deconditioning
- Stress
- Dietary factors, such as consuming too much caffeine
A low heart rate, or bradycardia, is associated with:
- Heart disease, including congenital defects
- Hypothyroidism
- Sleep apnea
- Electrolyte imbalances, including calcium and potassium deficiencies
- Side effects of medications, such as beta blockers and antidepressants
Vital Sign #3: Respiratory Rate
The respiratory rate is the number of full breaths taken per minute. It is measured at rest by watching the patient’s chest rise and fall.
The process is simple:
- Observe the person’s chest movements without making it obvious that you are monitoring their breathing, unintentional changes in breathing patterns may occur if the patient is anxious.
- Watch for the rise and fall of the chest or abdomen at rest to assess the respiratory pattern and rhythm.
- Count full breaths for 30 seconds and multiply the result by two.
The respiratory rate varies from 12 to 20 breaths per minute and like heart rate, it fluctuates based on age, activity level and physical fitness.
A high respiratory rate, or tachypnea, may be a symptom of:
- Anxiety
- Pain
- Deconditioning
- Heart or lung disease
- Electrolyte imbalances
- Heat stroke
- Infections
A low respiratory rate, or respiratory depression, is associated with:
- Central sleep apnea
- Liver failure
- Opioid or Alcohol use
Vital Sign #4: Blood Pressure
Blood pressure is the force of blood against the walls of the arteries. It is reported in millimeters of mercury, or mm Hg, using two numbers, the “systolic” blood pressure when the heart contracts over the “diastolic” blood pressure when the heart relaxes.
The procedure is straightforward:
- Position the patients with one arm at heart level.
- Select an appropriately sized cuff that covers approximately 80% of the upper arm
- Remove any restrictive clothing and wrap the deflated cuff around the patient’s arm, make it snug but not too tight. You should be able to comfortably slip two fingers under the cuff.
- Place the stethoscope over the brachial artery just below the cuff (front of the elbow).
- Inflate the cuff using the hand pump until the pressure exceeds the expected systolic blood pressure (usually 200-220).
- Gradually release the pressure by slowly opening the valve on the hand bulb, allowing the air to escape and deflate the cuff.
- Note the pressure reading (systolic) when you first hear a clear tapping or thumping sound. This represents the maximum pressure in the artery when the heart is contracting.
- Continue to deflate the cuff and listen for the sounds to fade away or become muffled.
- Note the pressure reading (diastolic) when the sounds completely disappear or become faint. This represents the minimum pressure in the artery when the heart is at rest.
Contraindications for brachial blood pressure readings include a history of surgery on the affected side, IV, and neurological issues. Alternate sites include the wrist and upper leg.
Normal blood pressure is typically around 120/80 with age-based variations.
High blood pressure readings could indicate:
- Primary hypertension
- Secondary hypertension caused by heart, lung, or kidney disease
- Stress
- Infection
- Dietary factors, such as high sodium consumption
Low readings suggest:
- Dehydration
- Anemia
- Pregnancy
- Malnutrition
- Severe infection
- Medication side effects
Vital Sign #5: Blood Oxygen Saturation
Peripheral oxygen saturation, or SpO2, is the percentage of oxygen in the bloodstream. It is measured using a fingertip device called a pulse oximeter that reads both oxygen level and heart rate.
To measure SpO2:
- Place the meter on a warm, clean fingertip, cold fingers and dark nail polish may cause artificially low readings.
- Allow the meter to establish a reliable signal, readings may take up to a minute.
Pulse oximeters provide a non-invasive and convenient method for measuring oxygen saturation, but they have limitations. If a patient has a low reading and no respiratory symptoms, try another finger, or check the battery in the unit.
Normal SpO2 ranges from 92-100% based on the patient’s health, but the interpretation is complex.
A low reading could be the result of:
- Heart or lung disease
- Anemia
- Respiratory infections, including pneumonia
- Deoxygenation
Readings in the high range that are normal for some people could signal problems for patients with obstructive pulmonary diseases.
Why Do Medical Assistants Take Vital Signs?
Vital signs play several important roles in medical decision-making.
As a medical assistant, the readings you take help the doctor:
- Establish a baseline — baseline measurements serve as a reference point for future assessments or comparisons.
- Diagnose disease — vital signs are important clues that point doctors in the right direction when investigating the cause of an illness.
- Monitor the effects of treatments, including some types of drugs — some heart medications may cause side effects that impact pulse and blood pressure. Abnormal readings may indicate the need for a dose adjustment.
How Do You Learn How to Take Vital Signs?
Medical assisting students learn to take vital signs during their program. First, you will learn about the science in the classroom, and then experienced instructors will walk you through the process of taking each vital sign. You will have the opportunity to practice in laboratory and real-world settings until you feel fully confident in your skills.
Final Thoughts
Medical assistants perform many important tasks to support the doctors and nurses they work with. But few tasks are as essential as taking vital signs. It is the foundation of quality care.
Want to Learn More?
Now that you know more about the duties of a medical assistant, it is time to learn more about Florida National University and our medical assistant programs. Start a rewarding career as a medical assistant today and help serve your community.
The purpose of the Medical Assistant Diploma program is to prepare the student as a multi-skilled medical assistant. This is done through the acquisition of the knowledge and skills that are necessary to work in clinical and administrative settings at hospitals, clinics, medical Labs, diagnostic centers, and doctor’s offices. In addition, the program offers options for entry-level positions such as front office procedures, back office procedures, and back office procedures. Florida National University students will be able to apply for the American Registry for Medical Assistants (ARMA) registry.
The Medical Assistant Technology Associate of Science program prepares the student for entry level employment as a medical assisting technologist in administrative and clinical settings such as hospitals, clinics, medical Labs, diagnostic centers, and medical offices. The program includes a fifteen-credit-hour component of general education/liberal arts courses. The student is prepared for challenging the CMA (Certified Medical Assistant) and the RMA (Registered Medical Assistant) certification examinations, and the National Certification exam of Phlebotomy. FNU awards an Associate of Science Degree upon completion of the program.
If you are interested in medical assisting, let Florida National University answer any questions you may have. Contact us today to learn more about our medical assistant diploma programs.
