Variations by age

Children and infants have respiratory and heart rates that are faster than those of adults as shown in the following table:

Age	Normal heart rate (beats per minute)	Normal respiratory rate (breaths per minute)
Newborn	100-160	30-50
0–5 months	90-150	25-40
6–12 months	80-140	20-30
1–3 years	80-130	20-30
3–5 years	80-120	20-30
6–10 years	70-110	15-30
11–14 years	60-105	12-20
14+ years	60-100	12-20

Additional signs

Vital signs are measures of various physiological statistics often taken by health professionals in order to assess the most basic body functions. Vital signs are an essential part of a case presentation. While various additional signs have been proposed, none have been officially universally adopted due to the expense in obtaining equipment required to diagnose and the difficulty in training entry-level professionals.

However, body mass index (ratio of height to weight) has been introduced in recent years as an additional vital sign that is easy to measure and indicative of disease risk.

Fifth sign

The phrase "fifth vital sign" usually refers to pain, as perceived by the patient on a Pain scale of 0–10. For example, the Veterans Administration made this their policy in 1999. However, some doctors have noted that pain is actually a subjective symptom, not an objective sign, and therefore object to this classification.

Other sources include pulse oximetry as their fifth sign.

Some sources consider pupil size, equality, and reactivity to light to be a vital sign as well.

Sixth sign

There is no standard "sixth vital sign", and the use is much more informal and discipline-dependent than with the above, but some proposals (excluding the fifth sign candidates above) include:

· Urinary continence
· End-tidal CO2
· Emotional distress
· Spirometry
· Glucose
· Functional Status
· Intracranial pressure
· Skin signs (color)
· Shortness of breath
· Molecular Genetics in Oncology

What is blood pressure?

Blood pressure, measured with a blood pressure cuff and stethoscope by a nurse or other healthcare provider, is the force of the blood pushing against the artery walls. Each time the heart beats, it pumps blood into the arteries, resulting in the highest blood pressure as the heart contracts. One cannot take his own blood pressure unless an electronic blood pressure monitoring device is used. Electronic blood pressure monitors may also measure the heart rate, or pulse.

Two numbers are recorded when measuring blood pressure. The higher number, or systolic pressure, refers to the pressure inside the artery when the heart contracts and pumps blood through the body. The lower number, or diastolic pressure, refers to the pressure inside the artery when the heart is at rest and is filling with blood. Both the systolic and diastolic pressures are recorded as "mm Hg" (millimeters of mercury). This recording represents how high the mercury column is raised by the pressure of the blood.

High blood pressure, or hypertension, directly increases the risk of coronary heart disease (heart attack) and stroke (brain attack). With high blood pressure, the arteries may have an increased resistance against the flow of blood, causing the heart to pump harder to circulate the blood.

According to the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH), high blood pressure for adults is defined as:

• 140 mm Hg or greater systolic pressure
  
  and
• 90 mm Hg or greater diastolic pressure

In an update of NHLBI guidelines for hypertension in 2003, a new blood pressure category was added called prehypertension:

• 120 mm Hg - 139 mm Hg systolic pressure
  
  and
• 80 mm Hg - 89 mm Hg diastolic pressure

The new NHLBI guidelines now define normal blood pressure as follows:

• Less than 120 mm Hg systolic pressure
  
  and
• Less than 80 mm Hg diastolic pressure

These numbers should be used as a guide only. A single elevated blood pressure measurement is not necessarily an indication of a problem. Your physician will want to see multiple blood pressure measurements over several days or weeks before making a diagnosis of hypertension (high blood pressure) and initiating treatment. A person who normally runs a lower-than-usual blood pressure may be considered hypertensive with lower blood pressure measurements than 140/90.

What is the respiration rate?

The respiration rate is the number of breaths a person takes per minute. The rate is usually measured when a person is at rest and simply involves counting the number of breaths for one minute by counting how many times the chest rises. Respiration rates may increase with fever, illness, and with other medical conditions. When checking respiration, it is important to also note whether a person has any difficulty breathing.

Normal respiration rates for an adult person at rest range from 15 to 20 breaths per minute. Respiration rates over 25 breaths per minute or under 12 breaths per minute (when at rest) may be considered abnormal.

How to check your pulse:

As the heart forces blood through the arteries, you feel the beats by firmly pressing on the arteries, which are located close to the surface of the skin at certain points of the body. The pulse can be found on the side of the lower neck, on the inside of the elbow, or at the wrist. When taking your pulse:

• Using the first and second fingertips, press firmly but gently on the arteries until you feel a pulse.
• Begin counting the pulse when the clock's second hand is on the 12.
• Count your pulse for 60 seconds (or for 15 seconds and then multiply by four to calculate beats per minute).
• When counting, do not watch the clock continuously, but concentrate on the beats of the pulse.
• If unsure about your results, ask another person to count for you.

If your physician has ordered you to check your own pulse and you are having difficulty finding it, consult your physician or nurse for additional instruction.

What is the pulse rate?

The pulse rate is a measurement of the heart rate, or the number of times the heart beats per minute. As the heart pushes blood through the arteries, the arteries expand and contract with the flow of the blood. Taking a pulse not only measures the heart rate, but also can indicate:

• heart rhythm
• strength of the pulse

The normal pulse for healthy adults ranges from 60 to 100 beats per minute. The pulse rate may fluctuate and increase with exercise, illness, injury, and emotions. Girls ages 12 and older and women, in general, tend to have faster heart rates than do boys and men. Athletes, such as runners, who do a lot of cardiovascular conditioning, may have heart rates in the 40's and experience no problems.

About glass thermometers containing mercury:

According to the Environmental Protection Agency (EPA), mercury is a toxic substance that poses a threat to the health of humans, as well as to the environment. Because of the risk of breaking, glass thermometers containing mercury should be removed from use and disposed of properly in accordance with local, state, and federal laws. Contact your local health department, waste disposal authority, or fire department for information on how to properly dispose of mercury thermometers.