Effect of Spinal Immobilization on Heart Rate, Blood Pressure and Respiratory Rate

2013 ◽  
Vol 28 (3) ◽  
pp. 210-214 ◽  
Author(s):  
Stevan R. Bruijns ◽  
Henry R. Guly ◽  
Lee A. Wallis
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Respiratory Rate ◽  
Null Hypothesis ◽  
Tissue Injury ◽  
Vital Signs ◽  
Clinical Situation ◽  
Repeated Measure ◽  
Publication Type ◽  
Spinal Immobilization

AbstractIntroductionVital signs remain important clinical indicators in the management of trauma. Tissue injury and ischemia cause tachycardia and hypertension, which are mediated via the sympathetic nervous system (SNS). Spinal immobilization is known to cause discomfort, and it is not known how this might influence the SNS and contribute to abnormal vital signs.HypothesisThis study aimed to establish whether the pain and discomfort associated with spinal immobilization and the maneuvers commonly used in injured patients (eg, log roll) affect the Heart rate (HR), Systolic Blood Pressure (SBP) and Respiratory rate (RR). The null hypothesis was that there are no effects.MethodsA prospective, unblinded, repeated-measure study of 53 healthy subjects was used to test the null hypothesis. Heart rate, BP and RR were measured at rest (five minutes), after spinal immobilization (10 minutes), following log roll, with partial immobilization (10 minutes) and again at rest (five minutes). A visual analog scale (VAS) for both pain and discomfort were also collected at each stage. Results were statistically compared.ResultsPain VAS increased significantly during spinal immobilization (3.8 mm, P < .01). Discomfort VAS increased significantly during spinal immobilization, after log roll and during partial immobilization (17.7 mm, 5.8 mm and 8.9 mm, respectively; P < .001). Vital signs however, showed no clinically relevant changes.DiscussionSpinal immobilization does not cause a change in vital signs despite a significant increase in pain and discomfort. Since no relationship appears to exist between immobilization and abnormal vital signs, abnormal vital signs in a clinical situation should not be considered to be the result of immobilization. Likewise, pain and discomfort in immobilized patients should not be disregarded due to lack of changes in vital signs.BruijnsS, GulyH, WallisL. Effect of spinal immobilization on heart rate, blood pressure and respiratory rate. Prehosp Disaster Med. 2013;28(2):1-5.

scholarly journals FRI0618-HPR EFFECTS OF MUSIC THERAPY ON PAIN, ANXIETY, AND VITAL SIGNS IN CHRONIC INFLAMMATORY RHEUMATIC DISEASES PATIENTS DURING BIOLOGICAL DRUGS INFUSION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 914.2-914
Author(s):  
S. Boussaid ◽  
M. Ben Majdouba ◽  
S. Jriri ◽  
M. Abbes ◽  
S. Jammali ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Music Therapy ◽  
Systolic Blood Pressure ◽  
Respiratory Rate ◽  
Vital Signs ◽  
Biological Therapies ◽  
Biological Drugs ◽  
Pain Anxiety ◽  
The Mean

Background:Music therapy is based on ancient cross-cultural beliefs that music can have a “healing” effect on mind and body. Research determined that listening to music can increase comfort and relaxation, relieve pain, lower distress, reduce anxiety, improve positive emotions and mood, and decrease psychological symptoms. Music therapy has been used greatly in various medical procedures to reduce associated anxiety and pain. Patients have a high level of anxiety when they are in the hospital, this is the case of patients with rheumatic diseases who consult regularly to have intravenous infusion of biological therapies.Objectives:The purpose of this study was to examine the effectiveness of music therapy on pain, anxiety, and vital signs among patients with chronic inflammatory rheumatic diseases during intravenous infusion of biological drugs.Methods:Fifty patients were divided into two groups: The experimental group G1 (n=25) received drug infusion while lestening to soft music (30 minutes); and the control group G2 (n=25) received only drug infusion. Measures include pain, anxiety, vital signs (blood pressure, heart rate and respiratory rate). The pain was measured using visual analogic scale (VAS). The state-trait anxiety inventory (STAI) was used for measuring anxiety, low anxiety ranges from 20 to 39, the moderate anxiety ranges from 40 to 59, and high anxiety ranges from 60 to 80. Vital signs (systolic blood pressure [SBP], diastolic blood pressure [DBP], heart rate [HR], and respiratory rate [RR]) were measured before, during and immediately after the infusion.Statistical package for social sciences (SPSS) was used for analysis.Results:The mean age in G1 was 44.45 years (26-72) with a sex ratio (M/F) of 0.8. Including the 25 patients, 12 had rheumatoid arthritis, 10 had ankylosing spondylitis and 3 had psoriatic arthritis. The mean disease duration was 8 years. In G2, the mean age was 46 years (25-70) with a sex ratio (M/F) of 0.75, 12 had rheumatoid arthritis, 11 had ankylosing spondylitis and 2 had psoriatic arthritis. The mean disease duration was 7.5 years. The biological drugs used were: Infliximab in 30 cases, Tocilizumab in 12 cases and Rituximab in 8 cases.Before the infusion, the patients of experimental group had a mean VAS of 5/10±3, a mean STAI of 50.62±6.01, a mean SBP of 13.6 cmHg±1.4, a mean DBP of 8.6 cmHg±1, a mean HR of 85±10 and a mean RR of 18±3. While in control group the mean VAS was 5.5±2, the mean STAI was 50.89±5.5, the mean SBP was 13.4±1.2, the mean DBP was 8.8±1.1, the mean HR was 82±8 and the mean RR was 19±2.During the infusion and after music intervention in G1, the mean STAI became 38.35±5 in G1 versus 46.7±5.2 in G2 (p value=0.022), the mean SBP became 12.1±0.5 in G1 versus 13±1 in G2 (p=0.035), the mean DBP became 8.1±0.8 in G1 versus 8.4±0.9 in G2 (p=0.4), the mean HR became 76±9 in G1 versus 78±7 in G2 (p=0.04) and the mean RR became 17.3±2.1 in G1 versus 18.2±1.7 in G2 (p=0.39).This study found a statistically significant decrease in anxiety, systolic blood pressure and heart rate in patients receiving music interventions during biological therapies infusion, but no significant difference were identified in diastolic blood pressure and respiratory rate.Conclusion:The findings provide further evidence to support the use of music therapy to reduce anxiety, and lower systolic blood pressure and heart rate in patients with rheumatic disease during biological therapies infusion.References:[1] Lin, C., Hwang, S., Jiang, P., & Hsiung, N. (2019).Effect of Music Therapy on Pain After Orthopedic Surgery -A Systematic review and Meta-Analysis. Pain Practice.Disclosure of Interests:None declared

scholarly journals Just the Facts: Diagnosis and management of small bowel obstruction

CJEM ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 648-651
Author(s):  
Brit Long ◽  
Elisha Targonsky ◽  
Alex Koyfman
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Small Bowel Obstruction ◽  
Vital Signs ◽  
Oral Temperature ◽  
Include Blood Pressure

A 63-year-old female patient presents with abdominal pain, vomiting, and abdominal distention. She has previously had a cholecystectomy and hysterectomy. She has had no prior similar episodes, and denies fever, hematemesis, or diarrhea. She takes no medications. Vital signs include blood pressure 123/61 mm Hg, heart rate 97, oral temperature 37.2°C, respiratory rate 18, oxygen saturation 97% on room air. Her abdomen is diffusely tender and distended.

scholarly journals Trajectories of vital status parameters and risk of mortality among acute organophosphorus poisoning patients – a latent class growth analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Waqas Ahmed Farooqui ◽  
Mudassir Uddin ◽  
Rashid Qadeer ◽  
Kashif Shafique
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Respiratory Rate ◽  
Oxygen Pressure ◽  
Latent Class ◽  
Vital Signs ◽  
Partial Oxygen Pressure ◽  
Risk Of Mortality ◽  
Partial Oxygen

Abstract Background Acute organophosphorus (OP) poisoning is one of the major causes of mortality among patients presenting to emergency departments in developing countries. Although various predictors of mortality among OP poisoning patients have been identified, the role of repeated measurements of vital signs in determining the risk of mortality is not yet clear. Therefore, the present study examined the relationship between trajectories of vital signs and mortality among OP poisoning patients using latent class growth analysis (LCGA). Methods This was a retrospective cohort study using data for 449 OP poisoning patients admitted to Civil-Hospital Karachi from Aug’10 to Sep’16. Demographic data and vital signs, including body temperature, blood pressure, heart rate, respiratory rate, and partial-oxygen pressure, were retrieved from medical records. The trajectories of vital signs were formed using LCGA, and these trajectories were applied as independent variables to determine the risk of mortality using Cox-proportional hazards models. P-values of < 0.05 were considered statistically significant. Results Data for 449 patients, with a mean age of 25.4 years (range 13–85 years), were included. Overall mortality was 13.4%(n = 60). In trajectory analysis, a low-declining systolic blood pressure, high-declining heart rate trajectory, high-remitting respiratory rate trajectory and normal-remitting partial-oxygen pressure trajectory resulted in the greatest mortality, i.e. 38.9,40.0,50.0, and 60.0%, respectively, compared with other trajectories of the same parameters. Based on multivariable analysis, patients with low-declining systolic blood pressure were three times [HR:3.0,95%CI:1.2–7.1] more likely to die compared with those who had a normal-stable systolic blood pressure. Moreover, patients with a high-declining heart rate were three times [HR:3.0,95%CI:1.5–6.2] more likely to die compared with those who had a high-stable heart rate. Patients with a high-remitting respiratory rate were six times [HR:5.7,95%CI:1.3–23.8] more likely to die than those with a high-stable respiratory rate. Patients with normal-remitting partial oxygen pressure were five times [HR:4.7,95%CI:1.4–15.1] more likely to die compared with those who had a normal-stable partial-oxygen pressure. Conclusion The trajectories of systolic blood pressure, heart rate, respiratory rate and partial-oxygen pressure were significantly associated with an increased risk of mortality among OP poisoning patients.

scholarly journals Evaluating the Accuracy of the VitalWellness Device

Iproceedings ◽  
10.2196/16250 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e16250
Author(s):  
Nicole Polanco ◽  
Sharon Odametey ◽  
Neda Derakhshani ◽  
Mark Khachaturian ◽  
Connor Devoe ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Standard Deviation ◽  
Body Temperature ◽  
Respiratory Rate ◽  
Linear Relationship ◽  
Vital Sign ◽  
Skin Color ◽  
Vital Signs ◽  
Mean Difference

Background Wellness devices for health tracking have gained popularity in recent years. Additionally, portable and readily accessible wellness devices have several advantages when compared to traditional medical devices found in clinical environments The VitalWellness device is a portable wellness device that can potentially aide vital sign measuring for those interested in tracking their health. Objective In this diagnostic accuracy study, we evaluated the performance of the VitalWellness device, a wireless, compact, non-invasive device that measures four vital signs (blood pressure (BP), heart rate (HR), respiratory rate (RR), and body temperature using the index finger and forehead. Methods Volunteers age ≥18 years were enrolled to provide blood pressure (BP), heart rate (HR), respiratory rate (RR), and body temperature. We recruited participants with vital signs that fell within and outside of the normal physiological range. A sub-group of eligible participants were asked to undergo an exercise test, aerobic step test and/or a paced breathing test to analyze the VitalWellness device’s performance on vital signs outside of the normal physiological ranges for HR and RR. Vital signs measurements were collected with the VitalWellness device and FDA-approved reference devices. Mean, standard deviation, mean difference, standard deviation of difference, standard error of mean difference, and correlation coefficients were calculated for measurements collected; these measurements were plotted on a scatter plot and a Bland-Altman plot. Sensitivity analyses were performed to evaluate the performance of the VitalWellness device by gender, skin color, finger size, and in the presence of artifacts. Results 265 volunteers enrolled in the study and 2 withdrew before study completion. Majority of the volunteers were female (62%), predominately white (63%), graduated from college or post college (67%), and employed (59%). There was a moderately strong linear relationship between VitalWellness BP and reference BP (r=0.7, P<.05) and VitalWellness RR and reference RR measurements (r=0.7, P<.05). The VitalWellness HR readings were significantly in line with the reference HR readings (r=0.9, P<.05). There was a weaker linear relationship between VitalWellness temperature and reference temperature (r=0.3, P<.05). There were no differences in performance of the VitalWellness device by gender, skin color or in the presence of artifacts. Finger size was associated with differential performance for RR. Conclusions Overall, the VitalWellness device performed well in taking BP, HR, and RR when compared to FDA-approved reference devices and has potential serve as a wellness device. To test adaptability and acceptability, future research may evaluate user’s interactions and experiences with the VitalWellness device at home. In addition, the next phase of the study will evaluate transmitting vital sign information from the VitalWellness device to an online secured database where information can be shared with HCPs within seconds of measurement.

scholarly journals The impact of vital signs on the death of patients with new coronavirus pneumonia: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Meixia Du ◽  
Jie Zhao ◽  
Xiaochun Yin ◽  
Nadi Zhang ◽  
Guisen Zheng
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
Body Temperature ◽  
Respiratory Rate ◽  
Meta Analysis ◽  
Vital Signs ◽  
The Body ◽  
Survival Group ◽  
The Impact

Background: Assessing the impact of vital signs (blood pressure, body temperature, heart rate, respiratory rate, and oxygen saturation) on the death of patients with new coronavirus pneumonia would provide a simple and convenient method for the monitoring of subsequent illness, and therefore, in some degree reduce treatment costs and increase the cure rate clinically. Methods: Six databases were retrieved. The software R 3.6.2 was used for meta-analysis of the included literature. Results: 12 studies were included, which comprise 8996 patients affected with COVID-19 infection. The meta-analysis study found that blood pressure (MAP, SBP and DBP), heart rate, respiration rate and SpO2 are the risk factors for disease progression in patients with COVID-19. Among them, the increase in MAP and the decrease in SpO2 have the greatest impact on the death of patients with COVID-19 [MAP: MD = 5.66, 95% CI (0.34, 10.98), SpO2: MD = -5.87, 95% CI (-9.17, -2.57), P = 0.0005]. However, comparing the body temperature of the death group and the survival group found that the body temperature was not statistically significant between the two groups [body temperature: MD = 0.21, 95% CI (-0.01, 0.43), P = 0.0661]. Conclusion: The increase in MAP, heart rate and respiratory rate, as well as the decrease in SBP, DBP and SpO2 are all independent risk factors for death in patients with COVID-19. These factors are simple and easy to monitor, and individualized treatment can be given to patients in time, reducing the mortality rate and improving treatment efficiency.

scholarly journals Effects of Surah Al-Rehman on pain, oxygen-saturation, and vital signs in post CABG patients: A Pilot Study

2021 ◽  
Vol 4 (1) ◽  
pp. 32-38
Author(s):  
Muhammad Imran ◽  
Raisa Begum Gul ◽  
Shumaila Batool
Keyword(s):  
Blood Pressure ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Tertiary Care ◽  
Vital Signs ◽  
Saturation Level ◽  
Repeated Measure ◽  
Pain Level ◽  
Oxygen Saturation Level ◽  
Cabg Patients

Objective: The main objective of the study was to determine the effects of Surah Al-Rehman on post CABG patients’ pain level, oxygen saturation, and vital signs. Methodology: A quasi-experimental pre and post-test design was used with a sample size of 60 patients in two tertiary care Hospitals, from July 2018 to September 2018. A non-probability convenient sampling method was used to recruit the participants. Post CABG adult Muslim patients were the study participants. Surah Al-Rehman’s recitation in the voice of the Qari Abdul Basit was the intervention for the current study. At a significance level of p-value ≤ 0.05, a repeated measure ANOVA was applied to determine the effects of Surah Al-Rehman on the outcome variables, which were patient’s pain level, oxygen saturation level, and vital signs including heart rate [HR], respiratory rate [RR], systolic and diastolic blood pressure. Results: Overall, Surah Al Rehman had shown statistically significant effects on the participants’ pain level (p<0.001), oxygen saturation level (p=0.01), respiratory rate (p<0.001), and diastole blood pressure (DBP, p=0.04). A minimum change in the pre and post values of HR and systolic blood pressure (SBP) was also observed, but statistically, this change was insignificant (HR, p=0.13 & SBP, p=0.47). Conclusion: Findings of the current study demonstrated that listening to the recitation of Surah Al-Rehman could decrease pain level, RR, DBP and enhance oxygen-saturation in post CABG patients.

scholarly journals Changes in Respiratory Rate, Blood Pressure and Heart Rate Variability in Rabbits during Orthostasis

2006 ◽  
Vol 75 (1) ◽  
pp. 3-12 ◽  
Author(s):  
J. Mokrý ◽  
T. Remeňová ◽  
K. Javorka
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Respiratory Rate ◽  
Supine Position ◽  
Spectral Power ◽  
Systemic Blood Pressure ◽  
Microcomputer System ◽  
Systemic Blood ◽  
Frequency Bands

The purpose of the study was to evaluate the changes of respiratory rate, systemic blood pressure and heart rate variability parameters (HRV) during orthostasis in anaesthetized rabbits. Furthermore, these changes were influenced by affecting the renin-angiotensin-aldosterone (RAA) system and autonomic nervous system (ANS) to study the mechanisms participating in activity of spectral frequency bands of HRV in rabbits. Ten adult rabbits (Chinchilla) were anaesthetized by ketamine and flunitrazepam. The systemic blood pressure, tidal volume and respiratory rate were measured. HRV was evaluated by microcomputer system VariaPulse TF3E. The R-R intervals were derived from the electrocardiogram signal from subcutaneous needle electrodes. The evaluation of HRV in very low (VLF; 0.01-0.05 Hz), low (LF; 0.05-0.15 Hz) and high frequency bands (HF; 0.15-2.0 Hz) was made and parameters of frequency and time analysis were calculated. The measurements were made in horizontal (supine) position, in orthostasis (the angle of 60 °) and again in supine position before and after enalapril (0.5 mg/kg b.w.), metipranolol (0.2 mg/kg b.w.), and after subsequent bilateral cervical vagotomy. The orthostasis in anaesthetized rabbits is accompanied by depression of respiratory rate reversed only by vagotomy. Furthermore, decrease of systemic blood pressure, unchanged heart rate and increased characteristics of heart rate variability were found, with predominant increase of spectral power in LF and VLF bands. This elevation can be eliminated only by complete blockade of ANS. Although the participation of ANS or RAA system in modification of individual HRV frequency bands is not as specific as in humans, we confirmed the participation of RAA system in determination of the VLF band.

Advance Monitoring of Blood Pressure and Respiratory Rate Using De-Noising Auto Encoder

2021 ◽  
Author(s):  
Seung-Ho Park ◽  
Kyoung-Su Park
Keyword(s):  
Blood Pressure ◽  
Respiratory Rate ◽  
Vital Sign ◽  
Superficial Temporal Artery ◽  
Vital Signs ◽  
Pulse Signal ◽  
Temporal Artery ◽  
Sinus Arrhythmia ◽  
Vital Signs Monitoring ◽  
Vital Sign Measurement

Abstract As the importance of continuous vital signs monitoring increases, the need for wearable devices to measure vital sign is increasing. In this study, the device is designed to measure blood pressure (BP), respiratory rate (RR), and heartrate (HR) with one sensor. The device is in earphone format and is manufactured as wireless type using Arduino-based bluetooth module. The device measures pulse signal in the Superficial temporal artery using Photoplethysmograghy (PPG) sensor. The device uses the Auto Encoder to remove noise caused by movement, etc., contained in the pulse signal. Extract the feature from the pulse signal and use them for the vital sign measurement. The device is measured using Slope transit time (STT) method for BP and Respiratory sinus arrhythmia (RSA) method for RR. Finally, the accuracy is determined by comparing the vital signs measured through the device with the reference vital signs measured simultaneously.

Poor urinary output

2015 ◽  
Author(s):  
Hugo Farne ◽  
Edward Norris-Cervetto ◽  
James Warbrick-Smith
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Respiratory Rate ◽  
Urine Output ◽  
Junior Doctor ◽  
Physiological Role ◽  
Urinary Output ◽  
Adequate Blood Supply ◽  
Normal Urine ◽  
Average Size

You should ask the nurse: • What the trend is in urine output—has it been gradually decreasing, or suddenly stopped? If the latter, have they checked if the urinary catheter is blocked by flushing it? This is a rapidly reversible cause of poor urinary output. • What the observations are for the patient. Ask for the heart rate, blood pressure, respiratory rate, oxygen saturations, and temperature, so you can get an idea of how unwell the patient is. This will help you prioritize how soon you need to see the patient. Healthy adults have a urine output of about 1 mL/kg/hour. Oliguria refers to a reduced urine output and is defined variously as <400 mL/day, <0.5 mL/kg/hour, or <30 mL/hour. Anuria refers to the complete absence of urine output. Decreased urine output should be taken very seriously as it may be the first (and only) sign of impending acute renal failure. Untreated, patients may die from hyperkalaemia, profound acidosis, or pulmonary oedema due to the kidneys not performing their usual physiological role. Normal urine output requires: • adequate blood supply to the kidneys • functioning kidneys, and • flow of urine from the kidneys, down the ureters, into the bladder, and out via the urethra. Pathology affecting any of these requirements can result in poor urine output, which is why the differential diagnosis for poor urinary output is often classified as shown in Figure 22.1. In practice, as a junior doctor you want to diagnose and treat the prerenal and postrenal causes. If you come to the conclusion that it is a renal cause (by exclusion), call the renal physicians for an expert opinion. This is crucial in determining the diagnosis: • Adequate intake? Remember that an adult of average size will require about 3 L of fluid intake per 24 hours (30–50 mL/kg/day). Febrile patients will require an extra 500 mL for every 1 °C above 37.0 °C to compensate for increased loss of fluids from evaporation and increased respiratory rate.

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