critical values for vital signs

[AnthonyM83]

Would they be in a critical care or other nursing quickguide book or something like that? They have values for stuff like ICP and PCO2. Probably to simple to have them there, but just a thought.

[Dustdevil]

I'm still not exactly sure what you are getting at, as far as the use of these numbers. But there are clearly defined limits for blood pressure that define stages of hypertension.

The reference I have here at my desk, Current Medical Diagnosis and Treatment, 2006 edition, offers these parameters, which are pretty much universal:

• Normal: <120 systolic and <80 diastolic

Prehypertension: 120-139 systolic and 80-89 diastolic

Stage 1 Hypertension: 140-159 systolic and 90-99 diastolic

Stage 2 Hypertension: =/>160 systolic and =/>100 diastolic

• This same text also defines a "Hypertensive Urgency" as a systolic of >220 or a diastolic of >125 without symptoms.

A "Hypertensive Emergency" is defined as a diastolic >130 (or with emergent symptomology indicative of end-organ damage).

Hopefully, this is the kind of thing you are looking for.

[Just Plain Ruff]

ok let me try to explain this request to all of ya, since apparantly I wasn't clear from my initial post.

We have a computer system called Cerner. Cerner has computer based forms on their system. ONe is a vital signs form.

The forms have the following data items in them

Systolic blood pressure

diastolic blood pressure

Heart rate

Resp rate

Pulse ox

Temperature.

There are other items that they track but let's just take the above.

For each of these there are numbers(reference numbers that show up in different colors depending on what value is entered) behind them such as normal ranges, high ranges, critical highs and critical lows

These numbers are pre-defined by Cerner.

So lets say that for systolic blood pressure the nurse enters 180 Cerner defines this as a critical high. If the nurse enters 140 for systolic blood pressure it would register as in the High range. If the nurse puts in 40 for systolic bp then that is defined as critical low.

All the nurses want is where Cerner got those numbers and what reference that Cerner used and Cerner cannot give them the reference where they got their values.. Bear in mind this is a big Six Sigma site. It's a very familiar site but due to confidentiality reasons I cannot say what hospital.

they have their own ranges of critical highs and lows but they also do not have a reference for their ranges.

What they are wanting is a reference to document back if anything comes of it that they can come back and say in "Steadman's book of medical factoids(fake book but an example)", the critical values which are the ones that we chose are as follows.

Critical high systolic bp 180 or above

Critical high diastolic bp 140 or above

High systolic bp is 130 - 180

High diastolic bp is 110 - 140

normal bp 100-120/80-110

low bp 60-100/40-80

critical low bp <60/<40

Does that make sense??? In other words what manual or book did they use to get to their values.

Cerner just tells them - those are the recognized values but we don't have the source of recognition.

So I task you, and I actually wish Ace was still around, I need a verifiable source, either a textbook with values or a document with values. This is a huge six sigma site and they want sources.

[AnthonyM83]

Might Cerner have a medical director/advisor that gave them the numbers who you might contact or something along those lines. Cerner company itself might not know the sources, but individuals consulted by the company might?

[Just Plain Ruff]

Anthony, I went that route already and no-one can tell me the sources they just say- it's what we use.

I guess we have to go a different route.

[iMac]

I don't know that specific set of vitals would really ever be considered bad (except for an obvious 50/20 for BP, that wouldnt be so good). Every single one of us is different and might be able to with withstand certain vitals while the next person might not be able to live off of them. Also depends what it is you are looking for, the problem at hand. Pt itself, general health.

Most likely why there is probably nothing posted anywhere about vitals. There is nothing set in stone because no one patient is set in stone.

Experience is what will get you to understand what is bad and what isnt.