Vitals to Know
Vitals are key to reviewing a patient’s physical status and making decisions regarding next steps to evaluation and treatment. Always check with the nurse prior to seeing a patient in the acute setting.
Information below retrieved from: Smith-Gabai, Helen, Holm, Suzanne. (2017). Occupational Therapy in Acute Care. AOTA Press. & Millar, Stacy. Lab values in acute care therapy. Allied Health Ed. https://alliedhealthed.com/wp-content/uploads/2021/01/Lab-Values-Handout.pdf
Lab Values
Heart Rate: 50-120 bpm
Systolic Blood Pressure: 80-180 mmHg
Diastolic Blood Pressure: 40-110 mmHg
SPO2%: Above 90%
Respirations: 12-20 breaths per minute
Mean Arterial Pressure (MAP): 70-105 mmHg
Hemoglobin: > 8 gm/dL (Hgb < 7 gm/dL no occupational therapy or physical therapy)
Oxygen Delivery Methods
Standard nasal cannula: low flow oxygen, 1–6 L/min.
Venturi mask: high-flow enriched oxygen of a certain concentration. Provides FiO2 24%–40%.
Face mask: used for patients with nasal irritation. Provides FiO2 40%–60%.
Nonrebreathing face mask: Provides high concentrations of oxygen. Delivers FiO2 up to 90%.
Reservoir cannula: improves the efficiency of oxygen delivery (i.e., patients may be well oxygenated at lower flows).
High-flow warmed and humidified oxygen (HFNC): nasal or transtracheal. Delivers oxygen comfortably at high flows ranging from 30–60 L/min.
Continuous positive airway ventilation (CPAP): provides continuous positive pressure to maintain an open airway.
Bi-level positive airway ventilation (BiPAP):
Mechanical ventilation: a lifesaving intervention for patients with respiratory failure.
Imaging
Chest x-ray (to identify pulmonary edema).
Ultrasound (ruling out for DVT).
Magnetic resonance imaging (identifying a brain bleed).
Computed tomography (determining presence of pulmonary embolism).
Tubes, Lines, Drains
Central venous line (CVL)
Arterial line (A-line)
Venous and arterial femoral catheters
Femoral hemodialysis catheter
Femoral intra-aortic balloon pump (IABP)
Pulmonary artery catheter (e.g., Swan-Ganz)
Transvenous or epicardial pacemaker
Extracorporeal membrane oxygenation (ECMO)
Continuous renal replacement therapy (CRRT)
Endotracheal tube (ETT)
Tracheostomy tube (“Trach”)
Activity Orders
Bedrest: (Bedrest might be indicated in the case of new DVT or PE, CSF leak, or new internal bleed.)
Out of bed
Out of bed to chair
Other
Vasopressors or Sedatives
Vasopressors (e.g., norepinephrine, phenylephrine, vasopressin): Consider medical hold when doses are increasing, MAP is <60 or if patient is on >2 pressors.
Sedatives (e.g., propofol, dexmedetomidine, fentanyl): Consider medical hold if patient is obtunded or medical team is unable to safely reduce sedation for therapy.