NATIONAL SERVICE

TRAINING PROGRAM 1
MODULE 6: HEALTH PROGRAM VITAL SIGNS
 VITAL SIGNS INCLUDE THE HEART BEAT,
BREATHING RATE, TEMPERATURE AND

VITAL BLOOD PRESSURE. THESE SIGNS MAY BE

WATCHED, MEASURED AND MONITORED TO
SIGNS CHECK AN INDIVIDUAL’S LEVEL OF PHYSICAL
FUNCTIONING.
VITAL
NORMAL VITAL SIGNS CHANGE WITH AGE, SEX, WEIGHT, EXERCISE TOLERANCE AND
CONDITION. NORMAL RANGES FOR THE AVERAGE HEALTHY ADULT VITAL SIGNS ARE:

• BLOOD PRESSURE: 120/80 MM/HG

• BREATHING: 12-18 BREATHS PER MINUTE
• PULSE: 60-80 BEATS PER MINUTE (AT REST)
• TEMPERATURE: 97.8 DEGREES FAHRENHEIT/AVERAGE 98.6 FAHRENHEIT OR 36.5
TO 37.5 DEGREES CENTIGRADE
 DEFINED, AS THE RATE AT WHICH THE HEART
BEATS IN ONE MINUTE, PULSE RATE OR THE
HEART BEAT IS INDICATIVE OF THE HEALTH
OF THE PERSON. AS THE HEART PUMPS

PULSE BLOOD INTO THE BODY, THE BLOOD VESSELS

CLOSE TO THE WRIST, UPPER ARM AND
RATE NECK START PULSATING AND THROBBING,
WHILE THE NORMAL PULSE RATE FOR
CHART HUMANS IS USUALLY 60 TO 100 BEATS PER
MINUTE, THERE ARE CERTAIN MEDICAL
CONDITIONS SUCH AS CARDIAC
ARRHYTHMIA WHICH MAY ALTER THE
NORMAL PULSE RATE OF AN INDIVIDUAL.
PULSE RATE CHART

THE OTHER INFLUENCING FACTORS ARE THE PERSON’S AGE, GENDER AND
FITNESS LEVEL. SO AS TODDLER’S PULSE RATE IS SIGNIFICANTLY HIGH AT
AROUND 110 BPM WHICH IS ALMOST CLOSE TO AN ADULT’S PULSE RATE AFTER
A STRENUOUS EXERCISE. SIMILARLY FEMALES AGED 12 AND OLDER, TEND TO
HAVE FASTER HEART RATES THAN MEN. ALSO ATHLETES, WHO DO A LOT OF
CARDIOVASCULAR CONDITIONING, MAY HAVE HEART RATES NEAR 40 BEATS
PER MINUTE. IT IS ALSO OBSERVED THAT THE PULSE IS LOWER WHEN YOU ARE
AT REST AND INCREASES WHEN YOU ARE INVOLVED IN ANY STRENUOUS
EXERCISE.
 YOU CAN CHECK YOUR PULSE RATE BY PLACING
TIPS OF YOU INDEX, SECOND AND THIRD
FINGERS ON THE PALM SIDE OF YOU OTHER
WRIST, BELOW THE BASE OF THE THUMB OR ON
YOU LOWER NECK, ON EITHER SIDE OF YOUR

HOW TO WINDPIPE. NOW COUNT THE BEATS FOR 10

SECONDS AND MULTIPLY THIS NUMBER BY SIX
CALCULATE TO GET YOUR PULSE. NOW USE A PILSE RATE
CHART TO FIND OUT HOW WELL YOUR HEART IS
PULSE RATE? WORKING AND YOUR GENERAL HEALTH AND
FITNESS LEVELS. CHECKING YOUR PULSE RATES
WHEN RESTING, DURING EXERCISES OR AFTER
IT, CAN GIVE INFORMATION ABOUT THE OVERALL
FITNESS.
NORMAL PULSE
RATE CHART
RESTING PULSE RATE CHART: IT IS
OBSERVED THAT THE LOWER THE
RESTING HEART RATES, THE
HEALTHIER IS YOU HEART. FOR
CALCULATING THIS, YOU HAVE TO
SIT QUIETLY FOR 10 MINUTES
BEFORE CHECKING YOUR PULSE
RATES. HERE IS A TABLE TO
DEMONSTRATE THE IDEAL RESTING
HEART RATES.
NORMAL PULSE RATE CHART
100-
Babies to age 1:
160
Children aged 1 to 10: 60-140
Children aged 10+ and
60-100
adults:
Well-conditioned
40-60
athletes:
HOW TO TAKE A RADIAL PULSE
THE RADIAL ARTERY IS FOUND CLOSE TO THE INSIDE PART OF YOUR WRIST NEAR YOUR
THUMB. YOU WILL NEED A WATCH WITH A SECOND HAND TO COUNT YOUR PULSE. THE
FOLLOWING STEPS MAY HELP YOU TAKE YOUR RADIAL PULSE.

• BEND YOUR ELBOW WITH YOUR ARM AT YOUR SIDE. THE PALM OF YOUR HAND SHOUL
BE UP.

• USING YOUR MIDDLE (LONG) AND INDEX (POINTER) FINGERS, GENTLY FEEL FOR THE
RADIAL ARTERY INSIDE YOUR WRIST. YOU WILL FEEL THE RADIAL PULSE BEATING
WHEN YOU FIND IT. DO NOT USE YOUR THUMB TO TAKE THE PULSE BECAUSE IT HAS A
PULSE OF ITS OWN.
HOW TO TAKE A RADIAL PULSE
• COUNT YOUR RADIAL PULSE FOR A FULL MINUTE (60 SECONDS). NOTICE IF
YOUR PULSE HAS A STRONG OR WEAK BEAT.

• WRITE DOWN YOUR PULSE RATE, THE DATE, TIME AND WHAT WRIST (RIGHT
OR LEFT) WAS USED TO TAKE THE PULSE. ALSO WRITE DOWN ANYTHING YOU
NOTICE ABOUT YOUR PULSE, SUCH AS IT BEING WEAK, STRONG, OR MISSING
BEATS.

• THE RADIAL ARTERY IS AN EASY ARTERY TO USE WHEN CHECKING YOUR

HEART RATE DURING OR AFTER EXERCISE.
RESPIRATION
• RESPIRATION IS THE PROCESS THAT OCCURS WHEN OXYGEN IS INHALED
INTO THE LUNGS, CONVERTED INTO ENERGY VIA A CHEMICAL REACTION
AND EXPELLED AS CARBON DIOXIDE. NORMAL RESPIRATION IS AN
AUTOMATIC PROCESS AND DOES NOT REQUIRE CONSCIOUS EFFORT.
HOWEVER, IN THE CASE OF ILLNESS OR TRAUMA, A VICTIM’S
RESPIRATION RATE MAY BECOME UNUSUALLY HIGH OR LOW INDICATING
THE NEED FOR IMMEDIATE MEDICAL ATTENTION. THE RESPIRATORY RATE
IS SIMPLY THE NUMBER OF BREATHS AN INDIVIDUAL TAKES PER MINUTE.
NORMAL RANGE
BY AGE

• AVERAGE RESPIRATORY RATES BY AGE:

• NEWBORNS: 30-40 BREATHS PER MINUTE
• LESS THAN 1 YEAR: 30-40 BREATHS PER MINUTE
• 1-3 YEARS: 23-35 BREATHS PER MINUTE
• 3-6 YEARS: 20-30 BREATHS PER MINUTE
• 6-12 YEARS: 18-26 BREATHS PER MINUTE
• 12-17 YEARS: 12-20 BREATHS PER MINUTE
• ADULTS OVER 18: 12-20 BREATHS PER MINUTE
STEPS

• CONTACT AN EMERGENCY RESPONSE TEAM IMMEDIATELY

IN THE EVENT OF A SERVER TRAUMA OR MEDICAL CRISIS.
• MEASURE AN INDIVIDUAL’S RESPIRATORY RATE WHILE
HE/SHE IS AT REST. TRY NOT TO LET THE VICTIM BECOME
AWARE THAT YOU ARE MONITORING RESPIRATIONS IN
ORDER TO OBTAIN A MORE RELIABLE COUNT.
STEPS

• OBSERVE THE RISE AND FALL OF THE VICTIM’S CHEST

AND COUNT THE NUMBER OF RESPIRATIONS OUT LOUD
FOR ONE FULL MINUTE. ONE RESPIRATION CONSISTS OF
ONE COMPLETE RISE AND FALL OF THE CHEST, OR THE
INHALATION AND EXHALATION OF AIR. THE NORMAL
RESPIRATORY RATE FOR A HEALTHY ADULT AT REST IS
12 TO 20 BREATHS PER MINUTE.
STEPS

• CATEGORIZE THE RHYTHM, EASE AND STRENGTH OF THE

RESPIRATION. NORMAL RESPIRATION CONSISTS OF DEEP,
EVEN BREATHS DURING WHICH THE RIB CAGE FULL
CONTRACTS AND RELAXES. ABNORMAL RESPIRATION MAY
APPEAR SHALLOW AND RAPID, LABORED, SHALLOW AND
DEEP OR NOISY AND MAY INDICATE ILLNESS OR INJURY.
STEPS
• RECORD THE CURRENT TIME, RESPIRATORY RATE AND
RESPIRATORY CHARACTERISTICS, IF POSSIBLE.
• REPEAT THE ABOVE STEPS FOR MEASURING AND RECORDING
RESPIRATION RATE AND CHARACTERISTICS EVERY 10 MINUTES
IN AN EMERGENCY SITUATION. MAKE A NOTE OF ANY
SIGNIFICANT CHANGES AND RELAY THE INFORMATION TO
MEDICAL PERSONNEL.
TIPS

•IF FIRST AID IS BEING PERFORMED ON A VICTIM,

MONITOR RESPIRATION IMMEDIATELY AFTER
MONITORING HIS OR HER PULSE RATE. DO NOT INDICATE
TO THE VICTIM THAT YOU ARE NOW MONITORING
RESPIRATION AS HE MAY SUBCONSCIOUSLY CHANGE
THE RATE, DEPTH OR STRENGTH OF HIS BREATHING.
BODY TEMPERATURE
• WHAT IS BODY TEMPERATURE?
BODY TEMPERATURE IS A MEASURE OF THE BODY’S ABILITY TO GENERATE AND GET RID OF HEAT. THE BODY
IS VERY GOOD AT KEEPING ITS TEMPERATURE WITHIN A NARROW, SAFE RANGE IN SPITE OF LARGE
VARIATIONS IN TEMPERATURES OUTSIDE THE BODY.
WHEN YOU ARE NOT TOO HOT, THE BLOOD VESSELS IN YOUR SKIN EXPAND (DILATE) TO CARRY THE EXCESS
HEAT TO YOUR SKIN’S SURFACE. YOU MAY BEGIN TO SWEAT, AND AS THE SWEAT EVAPORATES, IT HELPS
COOL YOUR BODY. WHEN YOU ARE TOO COLD, YOUR BLOOD VESSELS NARROW (CONTRACT) SO THAT
BLOOD FLOW TO YOUR SKIN IS REDUCED TO CONSERVE BODY HEAT. YOU MAY START SHIVERING, WHICH
IS AN INVOLUNTARY, RAPID CONTRACTION OF THE MUSCLES. THIS EXTRA ACTIVITY HELPS GENERATE
MORE HEAT. UNDER NORMAL CONDITIONS, THIS KEEPS YOUR BODY TEMPERATURE WITHIN A NARROW,
SAFE RANGE.
BODY TEMPERATURE
WHERE IS BODY TEMPERATURE MEASURED?
YOUR BODY TEMPERATURE CAN BE MEASURED IN
MANY LOCATIONS ON YOUR BODY. THE MOUTH, EAR,
ARMPIT AND RECTUM ARE THE MOST COMMONLY USED
PLACES. TEMPERATURE CAN ALSO BE MEASURED ON
YOUR FOREHEAD.
BODY TEMPERATURE
WHAT IS NORMAL BODY TEMPERATURE?

MOST PEOPLE THINK OF A “NORMAL” BODY TEMPERATURE AS AN ORAL

TEMPERATURE OF 98.6F. THIS IS AN AVERAGE OF NORMAL BODY TEMPERATURES.
TOUR TEMPERATURE MAY ACTUALLY BE 1F (0.6C) OR MORE ABOVE OR BELOW
98.6F. ALSO, YOUR NORMAL BODY TEMPERATURE CHANGES BY AS MUCH AS 1F
(0.6C) THROUGHOUT THE DAY, DEPENDING ON HOW ACTIVE YOU ARE AND THE TIME
OF DAY. BODY TEMPERATURE IS VERY SENSITIVE TO HORMONE LEVELS AND MAY BE
HIGHER OR LOWER WHEN A WOMAN IS OVULATING OR HAVING HER MENSTRUAL
PERIOD.
BODY TEMPERATURE

A RECTAL OR EAR (TYMPANIC MEMBRANE)

TEMPERATURE READING IS 0.5 TO 1F (0.3C TO 0.6C)
HIGHER THAN AN ORAL TEMPERATURE READING. A
TEMPERATURE TAKEN IN THE ARMPIT IS 0.5 TO 1F (0.3
TO 0.6C) LOWER THAN AN ORAL TEMPERATURE READING.
PROCEDURE IN TAKING AN ORAL TEMPERATURE
• WASH YOUR HANDS.
• RINSE THERMOMETER IN COLD WATER IF KEPT IN A CHEMICAL SOLUTION, AND
WIPE DRY WITH TISSUE. RATIONALE: CHEMICAL TASTE IS BITTER.

• GRASP THERMOMETER WITH THUMB AND FOREFINGER AND SHAKE VIGOROUSLY

BY FLICKING WRIST IN DOWNWARD MOTION TO LOWER MERCURY LEVEL TO
BELOW 95-96 DEGREES.

• CHECK TEMPERATURE READING ON THERMOMETER.

• EXPLAIN PROCEDURE TO THE PATIENT.
PROCEDURE IN TAKING AN ORAL
TEMPERATURE
• PLACE THERMOMETER IN PATIENT’S MOUTH UNDER TONGUE AND ASK PATIENT TO HOLD LIPS
CLOSED.

• LEAVE IN PLACE 3 TO 5 MINUTES.

• REMOVE THERMOMETER AND WIPE IT WITH TISSUE FROM FINGERS DOWN TO BULB. DISCARD
TISSUE.

• READ TEMPERATURE BY ROTATING THERMOMETER UNTIL THE MERCURY LEVEL IS CLEARLY

VISIBLE. SHAKE THERMOMETER DOWN.

• WASH HANDS.
• RECORD PATIENT’S TEMPERATURE ACCORDING TO HOSPITAL PROCEDURE.
BLOOD PRESSURE
BLOOD IS CARRIED FROM THE HEART TO ALL PARTS OF YOUR BODY IN
VESSELS CALLED ARTERIES. BLOOD PRESSURE IS THE FORCE OF THE
BLOOD PUSHING AGAINST THE WALLS OF THE ARTERIES. EACH TIME THE
HEART BEATS (ABOUT 60-70 TIMES A MINUTE AT REST). IT PUMPS OUT
BLOOD INTO THE ARTERIES. YOUR BLOOD PRESSURE IS AS ITS HIGHEST
WHEN THE HEART BEATS, PUMPING THE BLOOD. THIS IS CALLED SYSTOLIC
PRESSURE. WHEN THE HEART IS AT REST, BETWEEN BEATS, YOUR BLOOD
PRESSURE FALLS. THIS IS THE DIASTOLIC PRESSURE.
BLOOD PRESSURE
BLOOD PRESSURE IS ALWAYS GIVEN AS THESE TWO NUMBERS, THE
SYSTOLIC AND DIASTOLIC PRESSURES. BOTH ARE IMPORTANT. USUALLY
THEY ARE WRITTEN ONE ABOVE OR BEFORE THE OTHER, SUCH AS 120/80
MMHG. THE TOP NUMBER IS THE SYSTOLIC AND THE BOTTOM THE
DIASTOLIC. WHEN THE TWO MEASUREMENTS ARE WRITTEN DOWN, THE
SYSTOLIC PRESSURE IS THE FIRST OR TOP NUMBER, AND THE DIASTOLIC
PRESSURE IS THE SECOND OR BOTTOM NUMBER (FOR EXAMPLE, 120/80).
IF YOUR BLOOD PRESSURE IS 120/80, YOU SAY THAT IT IS “120 OVER 80.”
STEPS IN TAKING A BLOOD PRESSURE
• GATHER THE EQUIPMENT. YOU WILL NEED S SPHYGMOMANOMETER (BLOOD
PRESSURE CUFF), STETHOSCOPE, PEN AND PAPER.

• NEXT YOU NEED TO IDENTIFY AND GREET THE PATIENT SO THAT THEY FEEL A LITTLE
MORE COMFORTABLE. YOU CAN DO SO BY SAYING SOMETHING LIKE ‘HI (PATIENT’S
NAME) MY NAME IS (YOUR NAME).

• THEN YOU WILL TELL THE PATIENT WHAT YOU ARE GOING TO DO. AGAIN THIS JUST
MAKES THEM FEEL COMFORTABLE. IT ALSO LETS THEM KNOW WHAT YOU ARE GOING
TO DO SO THEY ARE NOT SURPRISED WHEN YOU START DOING IT. YOU CAN DO SO BY
SAYING ‘I AM GOING TO TAKE YOUR PRESSURE.’
STEPS IN TAKING A BLOOD PRESSURE
• THEN YOU WILL ASK THE PATIENT TO EXPOSE ARM ON A FLAT SURFACE WITH ARM FACING
UPWARD. IF THE ARM IS FACING UPWARD IT IS EASIER TO GET TO THEIR BRACHIAL PULSE.

• NEXT YOU WILL EXPOSE THE ARM AS MUCH AS POSSIBLE BY ROLLING UP THE SLEEVE. BY
ROLLING UP THE SLEEVE IT MAKES IT EASIER TO HEAR THE BRACHIAL PULSE. YOU SHOULD
NOT ROLL UP THE SLEEVES IF THE SHIRT IS HEAVY OR TIGHT BECAUSE IT MAY DISRUPT THE
BLOOD FLOW. IF YOU ARE NOT ABLE TO ROLL THE SLEEVES YOU WOULD ASK THE PATIENT
TO PLEASE TAKE THEIR ARM OUT OF THE SLEEVE.

• NOW, SQUEEZE THE CUFF TOGETHER IN YOUR HANDS. THIS REMOVES ACCESS IN AIR SO
THAT IT IS EASIER TO PLACE THE CUFF ON THE ARM.
STEPS IN TAKING A BLOOD PRESSURE
• THEN YOU TURN THE VALVE OF THE CUFF CLOCKWISE TO CLOSE IT. CLOSE IT SO THAT THE
AIR DOES NOT ESCAPE WHEN I START TO PUMP THE CUFF.

• NOW YOU ARE READY TO PLACE THE CUFF AROUND THE UPPER PART OF THE ARM ABOUT 1
INCH BELOW THE ARMPIT.

• THEN YOU NEED TO LOCATE THE BRACHIAL PULSE WITH YOUR MIDDLE FINGER AND INDEX
FINGER. THE BRACHIAL PULSE IS FELT ON THE BRACHIAL ARTERY. THIS ARTERY IS ON THE
INSIDE OF YOUR ELBOW.

• NOW YOU ARE GOING TO PLACE THE EAR PIECES OF THE STETHOSCOPE INTO MY EARS.
THIS ENABLES YOU TO LISTEN FOR THE BLOOD PRESSURE.
STEPS IN TAKING A BLOOD PRESSURE
• NEXT YOU WILL PLACE THE DIAPHRAGM (THE LARGER SIDE LOCATED AT THE END OF THE
STETHOSCOPE) OF THE STETHOSCOPE OVER THE BRACHIAL PULSE SITE.

• YOU WILL HOLD THE RUBBER BULB THAT IS CONNECTED TO THE SPHYGMOMANOMETER IN THE PALM
OF YOUR HAND, THE ONE NOT HOLDING THE STETHOSCOPE.

• THEN YOU WILL INFLATE THE CUFF BY PUMPING THE BULB BETWEEN 170 TO 200 MMHG. BY
INFLATING THE CUFF TO HIGH IT CAN BE PAINFUL TO THE PATIENT. BY INFLATING IT TO LOW YOU MAY
NOT BE HIGH ENOUGH TO HEAR THEIR SYSTOLIC READING.

• NEXT YOU LOOSEN THE VALVE BY TURNING IT SLOWLY COUNTER CLOCKWISE WHILE LISTENING
CLOSELY FOR THE FIRST SOUND YOU HEAR. THIS SOUND IS CALLED THE SYSTOLIC READING. THEN
CAREFULLY LISTEN FOR THE LAST SOUND YOU HEAR. THIS SOUND IS CALLED THE DIASTOLIC READING.
STEPS IN TAKING A BLOOD PRESSURE
• THEN YOU NEED TO WRITE DOWN THE SYSTOLIC AND DIASTOLIC READINGS ON A PIECE OF
PAPER. YOU ALSO WRITE THEM DOWN AS SOON AS YOU KNOW THEM SO YOU DO NOT
FORGET.

• THEN YOU DEFLATE THE CUFF BY LOOSENING THE VALVE. TO LOOSEN YOU WILL TURN THE
VALVE COUNTER CLOCKWISE.

• THEN YOU REMOVE THE CUFF FROM THE PATIENT’S ARM.

• NOW YOU CAN TAKE THE EAR PIECES OF THE STETHOSCOPE OUT OF YOUR EARS.
• LAST YOU RECORD THE SYSTOLIC AND DIASTOLIC READING INTO THE CHART. THESE ARE THE
SAME READINGS YOU WROTE DOWN EARLIER ON THE PIECE OF PAPER.
BIBLIOGRAPHY
DELA CRUZ, SONIA G. (2005). NATIONAL DEVELOPMENT VIA NATIONAL SERVICE
TRAINING PROGRAM. MANDALUYONG CITY: BOOKS ATBP. PUBLISHING CORP

DEL ROSARIO, ED. D. (2012). RESURRECCION ET. AL. NATIONAL SERVICE TRAINING
PROGRAM 1. BULACAN: ST. ANDREW PUBLISHING HOUSE.

LEE, SERGIO J. (2007). NATIONAL SERVICE TRAINING PROGRAM: 2 ND EDITION. QUEZON

CITY: C & E PUBLISHING, INC.