critical values for vital signs

[Just Plain Ruff]

I've been tasked by a couple of nurses at the client I'm at to provide the following information and I'm at a loss

I need sources if possible with the info.

Normal vital sign values (hr, sys bp, dias bp, resp rate, pulse ox and the like) - I know these

what I cannot find a good source on is critical vital sign numbers.

I know what they should be but the nurses are adamant that I provide them a source for these numbers. preferably a scholarly source but a source none the less.

I've searched google, google scholar and Pubmed etc. I can't find a good scholarly source.

Anyone who can help me would be appreciative.

thanks

[Mastabattas]

I'm going to go check right after posting this...but for some of those, couldn't possibly the AHA be one source? Or maybe that's not the kind of source you're looking for...

Another thought is... find a textbook and find what THEY source.

Okay...off to AHA to explore for myself.

I realize this isn't an entirely helpful post...but you got ME thinking and for now it's all I've got. I'll ask around with some of the peeps that might know better...

[Mastabattas]

Ok...AHA as far as I could tell was useless for this particular request.

What about this though: http://medicine.ucsd.edu/clinicalmed/

It's "Scholarly" AND clinical based...

[NREMT-Basic]

Goodness. Are they just wanting to know what preferable vital sign ranges are for a person of a certain age category or...? I usually just go by what I learned in my EMT classes and some common sense. Have you tried Tabers? I have the newest edition and thought I havent yet checked it for this, it has a great many charts and values graphs, etc. I dont know if that would be scholarly enough for the nurses you speak of or not. If they are so adament, there must be a purpose in them asking...do you know what it is, or is this some kind of Zen riddle they have given you? I know the AHA now says something like 116/78 instead of 120/80 as the gold standard, but what about things like skin warm and dry, pupils perrl, pulse/hr between 60-100, resps 12-20? I mean these come out of Brady but I have seen them cited other places as well. I am curious to hear what their reasoning is for demanding that you research this. certainly it cant be your experience and knowledge they question. Cant wait to see what you say. Good luck.

[Asysin2leads]

Yeah, as NREMT said, there is no real definite 'critical' number for vitals, it all depends on the context... thats sort of the whole art of medicine thing... which I think nursing school is for... but who am I to say.

[ERDoc]

It also depends on what their definition of critical is and what they are using it for.

[Thunderchild145]

We have a system here (CernerWorks) and you put your values into the system and it actually comes out with that for you. High, Low, or Critical. I honestly don't know what a determanent for Critical is but like ERDoc said it all depends who you ask on what critical is.

[fiznat]

It seems to me that nurses should know better than to even ask for numbers like this. Yes, there are "normal" ranges for vital signs, but -as we all know- deviation outside of those norms isnt always cause for concern by itself. How about instead of providing these people with rigid, black and white objective guidelines, find a way to help educate them on the concept of "clinical presentation" instead.

[Mastabattas]

It seems to me that nurses should know better than to even ask for numbers like this. Yes, there are "normal" ranges for vital signs, but -as we all know- deviation outside of those norms isnt always cause for concern by itself. How about instead of providing these people with rigid, black and white objective guidelines, find a way to help educate them on the concept of "clinical presentation" instead.

I would have to agree with this. And I agree that the reason they are asking for something like this is also important.

If they are looking for finite numbers as a way of determining care then I worry. To say Pt X has VS of XX and therefore requires THIS care... without actually considering how the Pt presents is dangerous. Classic BLS scenario. Pt with slight ALOC, able to maintain airway, known diabetic, BGL comes back as 1.2... are you going to give him Oral Glucose or D50W? I have a friend who presents like this EVERY time. He can take the Oral and be fine. But if Nurses are looking for something that say black and white what care is rendered...frankly I would be scared to let them care for me (or my patients).

As instructors are always reminding us: treat the patient, NOT the machines... then so should we treat the patient above the vital signs.

[Just Plain Ruff]

ok, the nurses are wanting ranges of critical, abnormal and normal values. They know what the numbers should be but they cannot find any documentation on what those numbers are.

The product I work on has ranges but the nurses say that those numbers are a little off.

The company that provided those numbers cannot give them the rationale as to where they got these numbers nor do they have documentation on what those numbers are and how they were decided

I don't really care about their motivation behind wanting the numbers, it is physicians and nurses that are asking for these numbers.

They do not want to take the numbers given at face value as the ranges are really wide. I will try to get the ranges that they have been given and I'm sure you'll see why they are questioning.

The company that has provided the ranges often does things this way and does not have the documentation or rationale behind it. Heck, there are things that just aren't done right with the company at times.

But to ask me the motivation behind the request, I cannot answer that other than they want verifiable data that they have the source for. Everyone on this site get's their panties in a bundle when others don't cite references and this is all that the nursing group I'm working with has asked.

Seems that is motivation enough for me.