Inflate the cuff until you can no longer feel this pulse.ģ. Estimate an approximate systolic blood pressureĢ. Line up the cuff marker with the brachial artery slightly medial to the biceps brachii tendon. Wrap the cuff around the patient’s upper arm.ģ. Ensure the cuff size appears appropriate.Ģ. The NEWS2 score only assigns a score based on the systolic blood pressure, however, the diastolic blood pressure should be recorded on the chart. Measurement of blood pressure can be performed manually using a stethoscope and sphygmomanometer, or by using an automatic blood pressure monitor. Scale 2 has a target oxygen saturation of 88 – 92% and is used for patients at risk of hypercapnic respiratory failure (e.g.Scale 1 has a target oxygen saturation of ≥ 96% and is used for most patients.NEWS2 has two different scales for recording oxygen saturation: Figure 3. Assessing the respiratory rate. Assess the patient’s respiratory rate for 60 seconds. the expiratory phase is often prolonged in asthma exacerbations and in patients with COPD).ģ. Note any asymmetries in the expiratory and inspiratory phases of respiration (e.g. Palpation of the radial pulse at this stage purely to avoid making the patient aware you are directly observing their breathing, as this can itself alter the respiratory rate.Ģ. Whilst still palpating the radial pulse (but no longer counting it), assess the patient’s respiratory rate. Respiratory rate (RR) Assessing respiratory rateġ. anxiety, supraventricular tachycardia, hypovolaemia, hyperthyroidism). A pulse 100 bpm is known as tachycardia and also has a wide range of aetiologies (e.g.An irregular rhythm is most commonly caused by atrial fibrillation, but other causes include ectopic beats in healthy individuals and atrioventricular blocks. In healthy adults, the pulse should be between 60 – 100 bpm.
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The shorter the interval used, the higher the risk of obtaining an inaccurate result, so wherever possible, you should palpate for a full 60 seconds.įor irregular rhythms, you should measure the pulse for a full 60 seconds to improve accuracy.
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You can calculate the heart rate in a number of ways, including measuring for 60 seconds, measuring for 30 seconds and multiplying by 2 or measuring for 15 seconds and multiplying by 4. Once you have located the radial pulse, assess the rate and rhythm. Palpate the patient’s radial pulse, located at the radial side of the wrist, with the tips of your index and middle fingers aligned longitudinally over the course of the artery.Ģ. Wash your hands and don PPE if appropriate.Īsk if the patient has any pain before proceeding.ġ. Gain consent to proceed with recording observations (vital signs). Introduce yourself to the patient including your name and role.Ĭonfirm the patient’s name and date of birth.īriefly explain what the procedure will involve using patient-friendly language. You might also be interested in our OSCE Flashcard Collection which contains over 2000 flashcards that cover clinical examination, procedures, communication skills and data interpretation.