inside this video right here i'm going to break down the normal vital signs for an adult patient here we go [Music] hey everyone it's the paramedic coach here if you're new here my name is evan the paramedic coach this is the number one channel in the world for everything ems education if you are new here hit subscribe tap the notification bell and punch that like button for everybody watching this video right now and we are diving in to vital signs for ems vital signs for the adult patients and i'm going to break down why these vital signs are so important so you understand this cold now here we go so the first piece that we have here that we're going to talk about is the patient's blood pressure all right so i'm going to put over on the side here as i'm talking through these different vital signs some notes here for you on the side okay so first is blood pressure the normal patient blood pressure that we're looking for is 120 over 80. now i'm going to give you a few notes here to remember is 120 over 80 normal sure yes it's normal could you be 120 over 70 and is that okay yes it's okay now here's the reason why i'm saying this to you if we have a bottom number which is the diastolic top number is systolic the bottom number is diastolic okay so when we have a blood pressure let's say it was 130 over 90. that's it that is going to be actually a high blood pressure on the top numbers a little high the bottom number is actually very high so if i see a patient with a blood pressure of 120 over 70 they have some room to breathe in some textbooks nowadays they do so that 120 over 70 is normal others will say 120 over 80 is normal so i'm going to give you a range okay now 120 over 70 cool cool me 120 over 80. that's cool me too just know that there's a lot of confusion out there we've now cleared this up now what's a really high blood pressure let's say a stroke patient might have a blood pressure of 200 over 100 a chf patient in the early stages had a blood pressure of 180 over 100 right what about a patient who would maybe is bleeding out or severely dehydrated but wait their number b or in a state called shock okay well that's called hypoperfusion hypo not enough perfusion means am i getting blood around my body if i'm hypoperfused my blood pressure is low okay so the magic number is the systolic blood pressure of 90. i have all these organs in my body right we have a heart we have a liver right stomach all the organs if our blood pressure is not 90 systolic then we are not getting enough blood to our organs now some may say that this is a basic video oh it's the mean arterial pressure of 60. yes that's correct too for my advanced people out there but let's stick with the nice stark rule for now okay if we see a blood pressure undernight systolic we're not getting enough water organs that is a fact right there okay so now we understand blood pressure normally in the adult land let's move in to heart rate and pulse when i say heart rate you can see my heart monitor over here this if i was to hook a patient up to the ekg wires ekg leads that you're going to hear okay on the field and i show on the screen there that's a heart rate a pulse is something that you actually feel on the patients okay that's important to know okay they should be the same but just you're aware heart rate will be more on a screen the pulse is something that you feel with your fingers okay so when we're taking a pulse on a patient there's two main points that i really like okay now you're going to learn about the radial pulse right you're going to learn the brachial pulse you're going to learn about the carotid pulse the femoral pulse all that stuff okay when you're taking a pulse in a patient i want to give you a practical tip and then we'll go to numbers radial pulse on a lot of people is very easy to feel okay but sometimes just for some reason just can't feel it i've been there go wow i've had a hard time finding this pulse this pulse point right here is where you actually put the blood pressure cuff to hear your blood pressure this pulse point right here you can see the little ridge here and it comes up originally comes up right here put your fingers you can do it on yourself the pulse point is it feels so much stronger and easier to feel here than it does here you can still feel it right but you can feel the difference here so if you're struggling to get a pulse on somebody check here my advice now the normal pulse in an average adult is 60 to 100 right now let's talk about some special circumstances with pulse and why to be high and why below now let's talk about some special circumstances with pulse if we have someone who's an athlete right or they work out a lot you'll notice their polls can go below 60. it's not uncommon to find a pulse rate of 40 or 50 in people who work out a lot or athletes think about aerobics or weight training you can find their pulse breaker down that's not something to be scared of but if you see somebody with a pulse rate of under 60 you should ask them hey can i see a question i see your pulse here is 48 um do you run do you work out a lot and it'll tell you is that normal for you had anyone ever told you that before remember if they're in your ambulance they're calling for an emergency so you got to check this stuff out okay right so now let's talk about if the pulse is too low for bad reasons well there will be something called a heart block which is an electrical problem inside your heart that can make the heart rate too low and medications can overdoses can also make the heart rate too low as well now reasons why the pulse rate would be too high pain fear anxiety infection or exercise right exercise meaning you're actually like working out right now not at rest okay so if you're on the treadmill your heart rate isn't 60 right it's going to go up above 100. if you're in severe pain your heart rate will be above 100 right if you are have an infection inflammation in your body heart will go up okay again pain anxiety are usually the most common when we talk about a patient with a high heart rate i think about two different lands roll me on this one 100 to 150 is usually it's pain anxiety infection usually you'll see a heart rate of one 100 you know let's say 102 104 120 right if a heart rate becomes 140 150 160 especially over 150 plus it's usually a primary heart problem that we're having something that i want you to remember when you get into class okay now let's move on and talk about respiratory rate now respiratory rate in the adult patient means how many times your patient breathing in and out breathing in and out when you're in front of them a normal patient is going to breathe in and out between 12 and 20. if somebody is breathing under 12 breaths a minute this is a true medical emergency right and we need to help the patients with their ventilations ventilations meaning they need help getting oxygen carbon dioxide out of their body they're breathing at two low over rates a common test question will be you approach an unresponsive patient with a respiratory rate of eight what do you do we need to help them ventilate okay let's give you an example now if somebody has a respiratory rate of over 20 then in that case they're breathing very rapidly again pain anxiety are some of the most common culprits but some processes inside the body can cause you to breathe at a rapid rate okay so you want to keep that in mind as well as you're getting ready for school 12 of 20 is normal now the next thing i want to talk about is pulse sock symmetry with post oximetry what you're seeing so it's a little probe is you'll put on the patient's finger okay actually in pediatrics you can put it on their foot just to give you an idea but we try to do the hand in most people like adults so 94 to 99 is going to be a normal range for pulse oximetry okay now what is pulse oximetry it's also known as spo2 it measures how well oxygen is actually combining and attaching to your red blood cells in your body how well basically you're absorbing oxygen how is oxygen being absorbed into your body good or bad it's not uncommon to see a young pediatric they could have 99 to 100 percent on pulse oximetry right people who smoke it's not uncommon see their pulse oximetry 95 96 94 right somebody with copd or maybe a late stage heart condition may be 92 i need 34 and that's normal for them to live in that environment and they're actually taking supplemental oxygen to make sure their oxygen levels are where they need to be at least above 94 okay in most cases with these patients so that is your pulse like symmetry now there is a few more vital signs i want to talk to you about in this video two more actually and next one is blood glucose blood glucose if we a street nickname would be checking up blood sugar on a patient right the blood glucose level the bgl level is taken in patients maybe their alter mental status maybe they're a di a a diabetic patient altered mental status means that man or woman is confused okay a normal blood glucose could be anywhere from 70 to about 120 it's a guy what we're looking for with blood glucose right in my experience when a patient goes under 70 and somebody starts seeing some funky behavior under 60 no matter what kind of diabetic you are you usually start seeing some funky behavior 30s and 40s the patient's usually unresponsive on when you get there okay in my experience a quick note about diabetics is every diabetic acts different a diabetic could be at 60 and be unresponsive when someone else at 60 is still fine another one could be at 30 unresponsive and the other one the 30 is still fine it's but you need to know it's still low it's still a low number right so we need to get them back to a normal number for that patient okay if we were to go to a patient and their blood glucose was let's say 210 uh 3 30. um that would be hyperglycemia hyperglycemia is too much hypo is too little remember this in medicine if you didn't pick up on it already in this video hypo is not enough of whatever i'm talking about hyper is too much of whatever i'm talking about right so that's something very very important to remember now the last piece is going to be n title co2 and for i have a video on end tidal co2 which i'll try to link either above here or somewhere down below on end tidal co2 if i go over it for you but with end tidal co2 it stands for end tidal carbon dioxide so it could be on the breathing tube if the patient's inhibited which means it's a breathing tube in their trachea and you are ventilating the patient either via ventilator or through a bag valve okay now with end tidal co2 we are measuring the n tidal carbon dioxide of the patients right so when they're breathing out that last bit that's what we're measuring so the normal entitled co2 number is 35 to 45. it can be too low it can be too high 35 to 45 is sweet spot where we want to be with our patients now enzytle co2 is important in a variety of patients respiratory patients we can see a lot with intel co2 again on this heart monitor we can see a lot going on there and then the other thing as well intel co2 is confirmation that we've actually innovated the patient correctly because if we don't have a carbon dioxide number when we place a breathing tube the brain two might be in the stomach which isn't in the wrong place okay so those are all the main numbers and vials that you need to know we went through them all blood pressure respiratory rate pulse blood glucose pulse oximetry anti-co2 make sure you have these down colds before you answer emt class and man it's gonna be a lot easier for you now vital signs is one piece one little piece of you becoming an emt i've actually created an entire video series you can pick up right here online and get it now and actually give you a lifetime access to this entire prep course so if you're somebody right now getting ready for emt advanced emt or paramedic school or you are somebody getting ready for a national rastry that astronaut prep is in there as well click the link down below i'll give you a lifetime access to the program you see right here on the screen and my friends i will see you in the next video i'll see you there take care don't waste any time don't don't be hesitant and just do it because i know this program works and i know it's it got me to where i was where it's been a year without school from emt to hey i passed my test and 70 questions like go for it you could do it like do not hesitate and don't waste any time people that don't know you they need to they need this program this program is not a choice to me this program is a happy to take uh thousands and thousands of pages in the books and you just narrow it down and just make everything simple past the registry so uh this is great content man i promise you it's worth it took this with three weeks left to go in my class and i just i'm not sure if i would have been able to pass my course or the nremt first try without this course the fact like when i was taking the the national and i would read the question and i would be like whoa evan literally just went over this in the car so it's it really it helps i got to the point where i was just ready to spill all my knowledge onto this freaking test so i'm like you know what man just go ahead go for it open it up boom congratulations you passed it was um outside of having my children man it's probably not like the happiest day of my life you