10.12: Vital Signs and Pulse

Vital signs provide quick, essential information about how well major body systems are functioning and help clinicians detect changes in a patient’s health.

Master this section and you'll be able to:

• List and describe what each of the four basic vital signs measures.
• Identify normal adult vital sign ranges and recognize when values are abnormal.

Vital Sign

Vital signs are simple measurements that show how vital body systems are functioning. They help clinicians track a patient’s current condition and monitor changes over time. The following are the four primary measurements:

• Body temperature

• Pulse (heart rate)

• Blood pressure​

• Respiratory rate (breathing rate)

• Some settings also track oxygen saturation (SpO2), weight, pain, or blood glucose as additional "vital signs".​

Vital signs are important because they help detect or monitor medical problems. In fact, abnormal vital signs can indicate illness, injury, or problems in a body system, sometimes before other symptoms appear.​ Clinicians use them for quick triage, ongoing assessment, and as part of every health evaluation.​

Blood pressure will be explored in detail in the next section. For now, we will take a brief look at the other three main vital signs.

Body Temperature

Measures body heat and reflects core body functioning. Common routes of taking somebody's temperature include oral, tympanic, axillary, and rectal. Because temperature normally varies by location in the body, the route must always be documented. The method used depends on the patient’s age, cognitive status, level of consciousness, and health condition.

Normal oral temperature is about 98.6°F (37°C), but slight variations are normal.

In most clinical settings, body temperature is measured and recorded in degrees Celsius (ºC). ​​​​​

 

Arterial Pulse

Pulse is one of the key vital signs measured to assess heart and circulatory system health. Taking a pulse is a quick and important way to check how many times the heart beats per minute, as well as the rhythm and strength of those beats.

Pulse is the throbbing of arteries as blood is pushed through them each time the heart beats, creating a palpable rhythmic wave, usually felt at points where arteries run close to the skin. In a bit more technical terms: pulse represents the pressure wave that expands and recoils the artery when the heart contracts. It is palpated at many points throughout the body. ​Pulse is measured in beats per minute (bpm). It determines if a person’s heart is beating normally, too fast (tachycardia), or too slow (bradycardia).​

The most common locations to accurately assess pulse as part of vital sign measurement include radial, brachial, carotid, popliteal, and apical pulse as shown in the figure below.  In clinical practice, aspects like pulse rate, rhythm (regular or irregular), and strength (amplitude) are evaluated, as changes can point to various health conditions.​

A normal resting adult heart rate is generally 60–100 bpm, but normal ranges vary by age. Certain factors, such as pain, anxiety, fever, or crying in infants may temporarily raise the pulse.  In clinical practice, aspects like pulse rate, rhythm (regular or irregular), and strength (amplitude) are evaluated, as changes can point to various health conditions.​

Figure \(\PageIndex{1}\): Common Pulse Assessment Points. There are several major locations where a pulse can be easily palpated during a physical assessment. These pulse points lie close to the surface of the body where arteries run over firm structures like bone or dense connective tissue. Examples include the carotid pulse in the neck, the apical pulse over the heart (with slightly different landmarks for adults versus infants), the brachial pulse in the antecubital fossa near the biceps tendon, and the radial pulse at the wrist. These sites are routinely used to assess heart rate, circulation, and overall cardiovascular status in clinical settings.

Respiratory Rate

Respiration refers to the movement of air into and out of the lungs, with inspiration bringing air in and expiration moving air out. One respiratory cycle consists of one inspiration and one expiration, and the respiratory rate is the number of cycles per minute. Assessing the respiratory rate reflects how well the lungs and respiratory system are working.

Normal respiratory rates vary by age — adults typically breathe 10–20 times per minute, while infants may breathe 30–60 times per minute. Rhythm should be regular and evenly spaced in children and adults who are awake, although newborns and young infants often breathe irregularly. When counting respirations, also consider factors such as sleep, pain, and crying, which can temporarily change the rate.

In addition to rate and rhythm, the quality of breathing is important. Normal breathing is quiet, relaxed, and effortless. Signs such as noisy breathing, nasal flaring, use of neck or chest muscles, or leaning forward in a tripod position suggest respiratory distress. If a patient shows any new signs of difficulty breathing during assessment, it is essential to notify the health care provider immediately or follow your agency’s protocol.

Vital Signs Overview Summary Table 

This table summarizes the four primary vital signs assessed during a routine clinical examination. Temperature reflects the body’s core heat balance, pulse measures the number of heartbeats per minute, respiratory rate indicates breaths taken per minute, and blood pressure represents the force of blood pushing against arterial walls. Typical adult ranges are provided for reference and may vary slightly depending on individual health status.

Vital Sign	What It Measures	Typical Adult Range
Temperature	Core body heat	97.8–99.1°F (36.5–37.3°C) ​
Pulse	Heartbeats per minute	60–100 bpm
Respiratory Rate	Breaths per minute	12–16 breaths/min
Blood Pressure	Pressure of blood in arteries	~120/80 mmHg