'Is That Good?' Understanding Vital Signs
"Oxygen 96 percent and heart rate, 86."
"Is that good?" Bill looked up at me, puzzled, as I told him the results of his routine pulse oximetry and heart rate check.
"Yep, that’s good. It means that right now your body’s getting enough oxygen and also that your heart rate is not too fast or too slow."
He shrugged his shoulders and looked down. "Okay"¦ I guess."
Bill had only recently been diagnosed with COPD, so of course the numbers and lung information he was hearing were new to him. Learning that stuff can be overwhelming, no doubt about it. Yet, Bill had been coming to pulmonary rehab for a few weeks and getting his vital signs checked every time, and I was concerned because he still didn’t seem to have a very good idea of what these important numbers were saying about his health, or at least the status of his health on that day.
Are you like Bill? Do you get checked out by doctors or other health care professionals, listen politely to the numbers and findings, but have little or no idea what they mean? As a person with COPD you can - and should - know about basic vital signs and understand what they mean for you.
Today we’re going to go over a few basic vital signs and other findings. Keep in mind that this is generalized information for a varied population and you should always ask your personal physician who examines you and knows you well about the vital signs numbers that are best for you. You might have a number outside a considered norm, but one that’s perfectly safe for you. Also ask your doctor if he or she would recommend you obtain equipment for monitoring yourself at home, and if so, how to evaluate your results and what to watch for - not to treat yourself - but to know when to call for treatment or advice.
Here are four commonly checked vital signs (VS).
VS: Oxygen Saturation
What is it? The percentage of red blood cells that are saturated with oxygen
Equipment: Pulse oximeter
Acceptable result: Minimum of 92 percent. 100 percent is the highest possible.
VS: Heart rate
What is it? The number of times your heart beats in one minute
Equipment: Pulse oximeter, heart monitor, or your pulse taken manually, with two fingers on your wrist (check with a healthcare professional to learn how to take your pulse)
Acceptable result: Normal resting (when you’re sitting calmly) heart rate should be anywhere from 60 to100.
VS: Blood pressure (BP)
What is it? The pressure exerted upon the walls of your blood vessels when the blood is circulating through your body.
Equipment: Blood pressure cuff and stethescope (when taken manually), or automatic blood pressure cuff
Acceptable result: Normal resting (when you’re sitting calmly) BP should be120/80 or lower. Desired BP varies. For example, a BP of 90/60 is often considered low, but your doctor may want your BP to be kept low (as long as you don’t become lightheaded or dizzy), especially if he or she is concerned with disease of your blood vessels.
VS: Breath sounds / Lung sounds
What is it? The sound of the movement of air in and out of your lungs
Acceptable result: "Clear" breath sounds - a soft, but audible airflow, like a gentle breeze. "Adventitious" lung sounds are sounds we don’t want to hear - sounds that may indicate obstruction or other problems in the lungs. A few of these are:
Wheezes - High-pitched whistling or squeaky sounds. Can be caused by air flowing through a narrowed, or squeezed, bronchial airway.
Rales - A crackling sound similar to pulling Velcro apart or crushing dry breakfast cereal. Can indicate fluid build-up as in congestive heart failure or other fluid such as from a lung infection. Crackles are commonly heard in people with pulmonary fibrosis, even when they’re stable and feeling well. Crackling sounds may be "normal for them."
Rhonchi - A distorted airflow sound, akin to a snore or a lower-pitched wheeze, possibly indicating excess mucous in the large or small airways.
I hope this lesson in vital signs helps you have a better understanding of what’s going on with your health. And the next time I check Bill’s vital signs and say something like, "You have an oxygen saturation of 95 percent with a heart rate of 72. Your blood pressure is 110/70 and your breath sounds are clear," I hope he looks up and smiles, and with confidence says, "That’s good"
Jane M. Martin is a licensed respiratory therapist, teacher and the founder and director of http://www.Breathingbetterlivingwell.com and author of Breathe Better, Live in Wellness and Live Your Life With COPD, scheduled for release Spring, 2011.