VITAL SIGNS

Effective Date: 
Wed, 08/01/2007
Reviewed: 
Fri, 08/26/2011
Revised: 
Sun, 08/28/2011
Policy: 

It is the standard operating procedure at UCSC health center to obtain routine vital signs, (blood pressure, temperature, pulse, and respiratory rate), plus  LNMP, on all patients being evaluated for illness or injury.  Routine weight should be updated every 6 months, unless the patient presents for GI or weight related problems, in which case weight should be measured at that visit.

Orthostatic vital signs and weights should be obtained in all patients presenting with dizziness or nausea,  and vomiting or diarrhea, as well as Eating Disorder patients.

Peak flow monitoring is done for new patients with current asthma history as baseline, and for all patients with URI complaint and history of asthma, as well as all patients with cough longer than 2 weeks or complaint of shortness of breath or wheezing.  Oxygen saturation should be added if patient is symptomatic or falls in the yellow or red range in peak flow testing.

Exceptions:

  1. Vital signs are not required for Tb testing, allergy injections, routine immunization, or nursing treatments for warts.
  2. Vital signs are not required for follow-up visits for musculoskeletal trauma.
  3. Visits for non-illness reasons do not require vital signs, unless vital signs are part of the purpose of the visit (eg annual exam, physicals).   

It is generally up to the discretion of the treating clinician whether vital signs, or any particular vital sign, should be obtained.  Nursing and medical assistant staff should query the treating clinician if unsure regarding what vital signs to do.  As a general rule it is better to obtain vital signs unnecessarily than to fail to obtain vital signs when indicated.

Vital signs outside of the below parameters should be retaken right away (BP & pulse manually if original set on RoboNurse), documented in the Medical Record and immediately reported to a licensed person for determination of plan:

BP systolic <90 >160
BP diastolic <60 >100
Pulse <60/min >100/min
Orthostatic (changes between lying to standing) BPsys or dias drop of >10 points Pulseincrease of >15
Resp <12/min >30/min
Temp <96 F >101.5 F
O2 Sat <95% n/a
Peak Flow <300 n/a