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CRITICAL CARE Critical care: the eight vital signs of patient monitoring Malcolm Elliott and Alysia Coventry O ne of the traditional roles of nurses involves surveillance.This might include watching patients for changes in their condition, recognising early clinical deterioration and protection from harm or errors (Rogers et al, 2008). For over 100 years, nurses have performed this surveillance using the same vital signs: temperature, pulse, blood pressure, respiratory rate and in recent years, oxygen saturation (Ahrens, 2008). Prompt detection and reporting of changes in these vital signs are essential as delays in initiating appropriate treatment can detrimentally affect the patient’s outcome (Chalfin et al, 2007). …show more content…

The nurse must be able to interpret conflicting assessment findings such as these in light of the patient’s underlying pathophysiology. When measuring body temperature, a number of factors must be considered. Not only must the measuring device be correctly calibrated, but the nurse must also be aware of the difference in the core temperature between anatomical sites. For example, a study found significant differences in the accuracy and consistency of several commonly used devices for measuring temperature – tympanic, oral disposable, oral electric and temporal artery (Frommelt et al, 2008). This highlights the importance of regular calibration, correct use, accurate documentation (site of measurement and temperature reading) and consistency (using the same site) as ways of accurately identifying trends in the patient’s core temperature. No single thermometer or measurement site is recommended as best practice, but in order to ensure accuracy Malcolm Elliott is Lecturer, Faculty of Health Science and Community Studies, Holmesglen Institute, Victoria, Australia and Alysia Coventry is Lecturer, School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Victoria, Australia Accepted for publication: March 2012 621 Table 1. Eight vital signs Vital sign Physiology Influencing factors Temperature Controlled by Age

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