Vital Signs Measurement

This article was born spontaneously after one of the consultations. I realized that some things that are obvious to me and other doctors may be incomprehensible and confusing to other people. Basic Vital Signs like pulse, respiratory rate, pressure, and temperature are what can help everyone to assess their condition or the condition of a loved one at the moment.

At the same time, half of the Basic Vital Signs do not need any complicated devices and manipulations. They are available to everyone. For the other half, some devices will be needed, but they either have at every home or are sold en masse at the nearest pharmacy. So, let’s get started

Why Do We Need Basic Vital Signs?

Basic vital signs can be valuable tools for individuals who use drugs and adhere to the principles of harm reduction. Harm Reduction focuses on reducing the negative consequences associated with drug use while prioritizing the well-being and safety of individuals. Monitoring basic vital signs can serve several purposes in this context:

Overdose Prevention: Monitoring vital signs, particularly respiratory rate and heart rate, can help individuals and those around them recognize signs of overdose. Slowed or shallow breathing, decreased heart rate, or changes in consciousness can be indicators of an overdose. By regularly checking vital signs, individuals can identify potential overdose situations and take prompt action, such as administering naloxone (an opioid overdose reversal medication) and seeking medical help.

Risk Reduction: Drug use can affect vital signs, such as increasing heart rate, blood pressure, or body temperature. Monitoring these parameters can help individuals assess their own well-being and identify potential risks or adverse effects associated with drug use. By being aware of changes in vital signs, individuals can make informed decisions regarding drug consumption, adjust dosages, or seek medical attention if needed.

Personal Health Monitoring: Regular monitoring of vital signs can help individuals understand the impact of drug use on their overall health. It allows for tracking any persistent changes in vital signs over time, which may indicate the need for medical evaluation or support. By recognizing patterns or trends, individuals can make informed decisions about their drug use and take steps to mitigate potential risks.

Safer Consumption Practices: Monitoring vital signs can encourage individuals to adopt safer consumption practices. For example, individuals may check their pulse before, during, and after drug use to assess the impact on their cardiovascular system. They can also monitor their body temperature to prevent overheating or dehydration, especially in the context of stimulant drug use. By incorporating vital sign monitoring into their harm reduction strategies, individuals can prioritize their own well-being and minimize potential harm associated with drug use.

It is important to note that despite the accepted and fixed norms, vital signs can vary greatly from person to person, and in different periods of life for one person. Basic vital signs are influenced by such things as Physical Activity, Emotional and Psychological Factors, Age and Fitness Level, Lifestyle Factors, and Medical Conditions.

It is also important to note that while vital sign monitoring can provide valuable information, it is not a substitute for comprehensive healthcare or professional medical advice.

And the last disclaimer, but very important in my opinion, monitoring and analysis of basic vital signs should not become an obsession or compulsion. This is a healthy practice that should be a Harm Reduction tool and can even perform some sedative, distracting and anti-anxiety functions.

Heart Rate

Heart rate refers to the number of times your heart beats in one minute.

The heart rate is controlled by the electrical signals generated within the heart itself. The heart has a natural pacemaker called the sinoatrial (SA) node, located in the right atrium. The SA node initiates each heartbeat by sending out an electrical signal. This electrical signal spreads through the atria, causing them to contract and pump blood into the ventricles. The signal then reaches the atrioventricular (AV) node, which acts as a relay station, allowing a brief delay to ensure that the ventricles have enough time to fill with blood. From the AV node, the electrical signal travels through specialized conduction pathways called the bundle of His and the Purkinje fibers, which stimulate the ventricles to contract and pump blood out of the heart.

Monitoring your heart rate can provide valuable information about your cardiovascular health.

Pulse Measurement

Pulse refers to the rhythmic throbbing sensation you can feel in certain blood vessels, typically in your wrist (radial pulse) or neck (carotid pulse). It corresponds to the expansion and relaxation of the arterial walls as the blood is pumped by the heart.

When the heart contracts during each heartbeat, it ejects blood into the arteries, creating a surge of pressure. This surge propagates as a pressure wave through the arterial system. As the pressure wave reaches the peripheral arteries (such as those in the wrist or neck), it causes the arteries to expand and then relax, resulting in the pulsating sensation you can feel.

The normal resting pulse rate for adults is typically between 60 and 100 beats per minute. However, individual variations exist, and factors such as age, fitness level, and overall health can influence the pulse rate.

You can measure your pulse and know your heart rate at any time and without complicated devices. You will only need a watch or a stopwatch or a timer for this.

Place two fingers (typically index and middle finger) on your wrist or neck and count the beats for 60 seconds. Alternatively, you can count the beats for 30 seconds and multiply by 2, or count the beats for 15 seconds and multiply by 4 to get the beats per minute.

If you know yourself, the substance you have taken and suspect that discomfort, panic, and anxiety may be part of your natural reaction or may be potentiated by the substance, I strongly recommend not to be lazy, but to count the pulse according to the full scheme – in 60 seconds. At the time, concentrating on the pulse itself, the numbers, and the score – this can help distract from anxious and panicked thoughts and play the role of a stabilizing anchor.

When the heart rate is above 100 beats per minute, it’s called tachycardia. When the heart rate is below 60 beats per minute, it’s called bradycardia.

If you notice a consistently high or low pulse rate outside the normal range, or if you experience irregularities, such as skipped beats or a racing pulse, it is advisable to consult a healthcare professional for further evaluation.

Remember, while monitoring your pulse can provide helpful insights, it is not a definitive diagnostic tool. If you have concerns about your pulse or any other symptoms, it is always recommended to seek medical advice for a comprehensive evaluation and appropriate management.

Respiratory Rate

The respiratory rate refers to the number of breaths a person takes in one minute. It is an essential vital sign that provides insights into the functioning of the respiratory system, which includes the lungs, airways, and muscles involved in breathing.

The process of breathing involves inhaling oxygen-rich air and exhaling carbon dioxide, a waste product of cellular metabolism. The respiratory rate reflects the efficiency of this gas exchange process and the overall respiratory function.

Here is a breakdown of the mechanisms involved in respiratory rate:

1. Neural Control: Breathing is controlled by the respiratory centers in the brainstem, primarily the medulla oblongata. These centers send nerve impulses to the respiratory muscles, such as the diaphragm and intercostal muscles, instructing them to contract and initiate inhalation. The nerve signals also regulate the timing and depth of each breath.
2. Chemical Control: Chemoreceptors located in the carotid arteries and the aorta detect changes in the levels of oxygen, carbon dioxide, and pH in the blood. When oxygen levels decrease or carbon dioxide levels increase, the chemoreceptors send signals to the respiratory centers, increasing the respiratory rate to enhance oxygen uptake and eliminate excess carbon dioxide.

Respiratory Rate Measurement

As in the case of the pulse, you can measure your respiratory rate at any time and without complicated devices. You will only need a watch or a stopwatch or a timer for this. To measure your respiratory rate, observe the rise and fall of your chest or abdomen for 60 seconds, counting each breath. Alternatively, you can count the number of breaths for 30 seconds and then multiply that number by 2 to calculate the breaths per minute.

A normal respiratory rate for adults at rest is typically between 12 and 20 breaths per minute. If your respiratory rate is consistently outside this range, or if you experience difficulty breathing, persistent cough, or chest pain, it is advisable to seek medical attention

Monitoring your respiratory rate can help identify respiratory distress, such as rapid breathing (tachypnea) or slow breathing (bradypnea). An unusually high or low respiratory rate, along with other respiratory symptoms, may indicate respiratory infections, lung diseases, or other medical conditions requiring medical attention.

That was the easiest part. Let’s raise the level and move on to something more difficult.

Blood Pressure Principles

Monitoring blood pressure requires a device like a sphygmomanometer or blood pressure monitor, or blood pressure gauge. It sounds serious, but in fact, it is a simple device that was easy to use even before it became electronic, and now it is available to everyone.

However, the difficulty is that it will not be possible to measure blood pressure without a device, which means that the device must be directly accessible, and a person must be able to use it without unnecessary risks. This imposes certain restrictions, but I still want to talk about this important vital indicator.

I will not dwell on the technique of measuring blood pressure, because it depends on what you measure it with. For a classic blood pressure gauge, you will need detailed instructions (if the topic is interesting to anyone, I will definitely tell you about it separately), and for modern digital devices, it consists in following the manufacturer’s instructions.

Therefore, below I want to talk about what these indicators mean and how it all roughly works.

Blood pressure refers to the force exerted by circulating blood against the walls of the arteries as the heart pumps it throughout the body. It is typically measured using two numbers:

1. Systolic pressure represents the force when the heart contracts and pumps blood.
2. Diastolic pressure represents the force when the heart is at rest between beats.

The measurement is expressed as systolic pressure over diastolic pressure, such as “120/80 mmHg,” where “mmHg” stands for millimeters of mercury. Here’s how blood pressure is regulated and what the numbers indicate:

Cardiac Output: The heart plays a crucial role in blood pressure regulation. Cardiac output refers to the amount of blood pumped by the heart per minute. It is determined by the stroke volume (the amount of blood ejected with each heartbeat) and the heart rate (the number of heartbeats per minute – we discussed it at the very beginning). An increase in either the stroke volume or heart rate can raise blood pressure.

Peripheral Resistance: Peripheral resistance refers to the resistance encountered by blood flow in the arteries. It depends on factors such as the diameter and elasticity of the blood vessels and the viscosity of the blood. When peripheral resistance increases, blood pressure also increases.

Blood pressure is typically categorized as follows:

• Normal: Systolic pressure less than 120 mmHg and diastolic pressure less than 80 mmHg.
• Elevated: Systolic pressure between 120-129 mmHg and diastolic pressure less than 80 mmHg.
• Hypertension Stage 1: Systolic pressure between 130-139 mmHg or diastolic pressure between 80-89 mmHg.
• Hypertension Stage 2: Systolic pressure 140 mmHg or higher, or diastolic pressure 90 mmHg or higher.
• Hypertensive Crisis: Systolic pressure higher than 180 mmHg and/or diastolic pressure higher than 120 mmHg. Emergency medical attention is required.

High blood pressure (hypertension) can strain the heart and arteries, increasing the risk of cardiovascular diseases. Low blood pressure (hypotension) can cause inadequate blood flow to organs and tissues, resulting in symptoms like dizziness and fainting.

Monitoring blood pressure regularly is important for identifying any deviations from the normal range and managing hypertension. Lifestyle modifications, including regular physical activity, maintaining a healthy weight, adopting a balanced diet (low in sodium and high in fruits, vegetables, and whole grains), managing stress, and limiting alcohol, tobacco, and most substances use, can help control blood pressure.

Body Temperature

Body temperature refers to the measurement of the heat generated and maintained by the human body. It is an essential vital sign that provides valuable information about the body’s metabolic rate, overall health, and the balance between heat production and heat loss.

Body temperature is regulated by a part of the brain called the hypothalamus, which acts as the body’s thermostat. The hypothalamus receives signals from various temperature sensors located throughout the body, including the skin and internal organs. It then initiates appropriate responses to maintain the body’s core temperature within a narrow range.

Here’s how body temperature regulation works and what the different temperature measurements indicate:

Thermoregulation: The hypothalamus regulates body temperature through a process called thermoregulation. When the body’s core temperature rises above the set point, such as during physical activity or exposure to hot weather, the hypothalamus triggers mechanisms to cool the body, such as vasodilation (expansion of blood vessels near the skin surface), sweating, and increased respiration. Conversely, if the core temperature drops below the set point, such as in cold environments, the hypothalamus initiates mechanisms to conserve heat, such as vasoconstriction (narrowing of blood vessels), shivering, and piloerection (hair standing on end).

Normal Body Temperature: The average normal body temperature is around 36.5°C to 37.5°C (97.7°F to 99.5°F). However, individual variations exist, and factors such as age, activity level, time of day, and hormonal fluctuations can influence body temperature.

Methods of Measurement Body temperature can be measured using various methods, including oral (mouth), axillary (armpit), tympanic (ear), temporal artery (forehead), and rectal (rectum). Each method has its own accuracy and practical considerations. It would be rather boring and long to describe them. So I’m going to focus on something else.

Hypothermia occurs when the body’s core temperature drops below normal levels, typically below 35°C (95°F). It can result from exposure to cold environments, prolonged immersion in cold water, or certain medical conditions. Hypothermia is a medical emergency and requires immediate attention.

Hyperthermia and Drugs

Hyperthermia refers to an elevated body temperature above the normal range, typically resulting from an imbalance between heat production and heat dissipation. It is different from fever, which is a regulated increase in body temperature in response to an illness or infection. Hyperthermia can be caused by external factors, such as exposure to high temperatures or excessive physical exertion, or internal factors, such as certain medications or medical conditions.

Stimulants and certain drugs can contribute to hyperthermia by affecting the body’s thermoregulatory mechanisms or increasing heat production. Some examples include:

Drugs: Stimulant drugs such as amphetamines, methamphetamines, cocaine, and ecstasy (MDMA) can significantly increase body temperature due to their stimulatory effects on the central nervous system.

I especially want to mention MDMA here. A relatively safe substance with non-compliance with the basic principles of Harm Reduction has been proven to pose a threat to health and life precisely because of the development of malignant hyperthermia. Nightclubs with crowds of people and poor ventilation, ecstasy pills with impurities and large dosages, alcohol, and physical activity – all this create a predisposing background for the development of hyperthermia, unfortunately.

Medications: Certain medications, such as some antidepressants (e.g., serotonin-norepinephrine reuptake inhibitors – SNRIs) and antipsychotics, can interfere with the body’s ability to regulate temperature, leading to hyperthermia as a side effect.

Here separately cnjbn Here separately it is worth mentioning the use of substances against the background of treatment with medical psychoactive drugs drugs. This is always a very bad idea.

Serotonin Syndrome: Serotonin syndrome is a potentially life-threatening condition caused by excessive levels of serotonin in the brain. It can occur as a result of combining certain medications, such as selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), or other substances that somehow increase serotonin levels. Serotonin syndrome can cause symptoms including hyperthermia, agitation, muscle rigidity, and changes in mental status.

Recognizing and Dealing with Hyperthermia

It is very important to recognize hyperthermia in time for prompt intervention. Common signs and symptoms of hyperthermia include:

• Elevated body temperature: The body temperature may rise above 38°C (100.4°F) and continue to increase.
• Profuse sweating: The body attempts to dissipate heat by sweating excessively.
• Flushed or red skin: The skin may appear red or flushed due to increased blood flow near the skin surface.
• Rapid heart rate: Increased heart rate is a response to elevated body temperature.
• Headache, dizziness, or lightheadedness: These symptoms may occur as a result of the body’s attempt to cool down.
• Nausea, vomiting, or diarrhea: Hyperthermia can affect the gastrointestinal system and lead to these symptoms.

If you suspect hyperthermia, take the following steps:

1. Move to a cooler environment: Find a shaded or air-conditioned area to rest.
2. Remove excess clothing: Remove any unnecessary clothing and loosen tight clothing to facilitate heat dissipation.
3. Hydrate: Drink cool water or sports drinks to replace lost fluids and prevent dehydration.
4. Apply cool water or ice packs: Apply cool water to the skin or use ice packs on areas with a rich blood supply (such as the neck, armpits, or groin) to help lower body temperature.
5. Seek medical attention: If symptoms worsen, persist, or are accompanied by confusion, rapid breathing, or altered consciousness, it is important to seek immediate medical attention.

Remember, hyperthermia can be a serious condition, and early recognition and appropriate management are crucial. If you suspect hyperthermia or have concerns about elevated body temperature, it is advisable to consult a healthcare professional for further evaluation and guidance.

Summary

Here’s a summary of the information covered in our long long conversations on basic vital signs and their significance:

• Vital signs are essential measurements that assess a person’s general health and monitor their body’s physiological functions.
• The four basic vital signs are body temperature, heart rate, respiratory rate, and blood pressure.
• Body temperature reflects the balance between heat production and heat loss in the body, and it is regulated by the hypothalamus.
• Heart rate refers to the number of times the heart beats per minute and can be affected by factors such as physical activity, emotions, and certain medications.
• Respiratory rate is the number of breaths taken per minute and provides insights into the efficiency of the respiratory system and oxygenation.
• Blood pressure measures the force exerted by blood against the walls of blood vessels and consists of systolic and diastolic pressure readings.
• Monitoring vital signs helps assess overall health, detect early signs of illness, evaluate treatment responses, guide medical decision-making, and ensure patient safety.
• Hyperthermia is an elevated body temperature that can result from exposure to high temperatures, excessive physical exertion, or certain drugs/stimulants.
• Stimulants and certain drugs can contribute to hyperthermia by affecting thermoregulation or increasing heat production.
• Basic vital signs can be useful for individuals who use drugs and adhere to harm reduction principles, as they can help in overdose prevention, risk reduction, personal health monitoring, and safer consumption practices.