vITALS

VITAL SIGN REPORT GROUP

There are six reports available.  To meet criteria for the “Vitals - Set of Vital Signs Documented” report, you must document each of the following at least once per call.

·        Glasgow Coma Score Documented
·        Pulse Rate Documented
·        Respiratory Documented
·        Systolic Blood Pressure Documented
·        SpO2 Documented

These reports are available in ESO Analytics - Regional Reports - North Dakota - Rural EMS Counts.  Click on Benchmark to see where other North Dakota services are at.

WHY IS THIS MEASURE IMPORTANT

After level of consciousness, vital signs are one of the most objective points to determine if your patient is stable or unstable.  Each vital sign is necessary as it may indicate the patient’s level of distress.  As an example, a septic patient may have a normal blood pressure while simultaneously experiencing tachycardia.  It is important to measure each vital sign to have a comprehensive look at the patient’s hemodynamic status.

The following articles may show some age yet they still hold true today:

https://www.emsworld.com/article/10253321/valuable-vitals

https://www.emsworld.com/article/10320875/beyond-basics-putting-vital-back-vital-signs

https://www.fireengineering.com/fire-ems/the-importance-of-vital-signs/       

https://therneducator.com/how-to-take-pediatric-vital-signs/

How to document in your system to make the report work

See attached PowerPoint.

Administrators are able to turn on ESO rules to enforce documentation.

ESO ->  Admin -> EHR -> Vitals Tab -> Configurable Validation
Turn “On” the following rules:
·        Blood Pressure Required
·        Pulse Ox Required
·        Pulse Required
·        Respiration Rate Required
·        Vital Sign Require One GCS

Hacks to stay proficient

Integrate into regular training

When you talk about taking pulses in CPR class, have participants check each other’s pulse rates.  This is a great time to practice obtaining pulses where we usually don’t (brachial, carotid, etc).

Have each person take a coworker’s blood pressure during regular squad trainings.

Co-locate equipment necessary for a full set of vitals in one area of your portable kits (stethoscope, BP cuff, pulse oximeter). 

Hold a community blood pressure screening event where you not only take blood pressures but a full set of vitals for practice.

Develop a rehab plan and protocol for your local fire department.  NFPA 1584 is titled Standard on the Rehabilitation Process for Members During Emergency Operations and Training Exercises.  Many urban services require firefighters to have vitals assessed every two air bottles or every so many minutes in a scene doing heavy work.  There are several guidelines about triage and treatment.