NU2ICU V3 logoASSESSMENT – NORMAL VALUES

So whats normal?

When you’ve worked in health long enough you’ll know hardly anyone that’s sick enough to be in ICU is normal…

Pulse
Descriptors: regular, irregular, strong or weak

Consider; medications, pain, chest pain, dizziness, infection, other health issues, current values against patient’s normal

Adult 60 to 100 regular beats per minute
Less = Bradycardia    More = Tachycardia
 

Blood pressure

Consider; medications, pain, infection /sepsis / shock, chest pain, dizziness, current values against patient’s normal
Systolic Diastolic
Adult 90 to 140 mmHg 60 to 90 mmHg
Less = Hypotension   More = Hypertension   Diastolic issues can occur alone
 

Respirations

Descriptors: normal, shallow, labored (increased Work of Breathing), noisy, Kussmaul, irregular

Consider; medications, pain, sedation, chest pain, dizziness, other health issues, SaO2, current values against patient’s normal

Adult (normal) 12 to 20 breaths per minute
Less = Bradypnoea    More = Tachypnoea
 

Pulse Oximetry

Consider; quality of pleth tracing (pulse), sedation, Type 2 Resp Failure, current values against patient’s normal
Range Value Treatment
Normal 95 to 100% None
Mild hypoxia 91 to 94% Give low flow oxygen to SaO2 > 92%  <96%
Moderate hypoxia 86 to 90% Give high flow oxygen to SaO2 > 92%  <96%
Severe hypoxia <85% Give oxygen w/ positive pressure

 

 Urine Output

Consider; hydration status, diabetes, medications, pre-existing Chronic Renal Failure, current values against patient’s normal
Range Value
Normal > 720mls / day (>30 mls/hr)
Oliguria < 400mls /day (<17mls/hr)
Anuria < 50mls / day
Polyuria > 3000mls / day
 

Temperature

Consider; Hypothermia –  strokes, environmental exposure, diabetes, malnutrition, bacterial infection, thyroid disease, spinal cord injuries, medications, current values against patient’s normal

Consider; Hyperthermia –  environmental exposure, bacterial infection, neuroleptic malignant syndrome, thyroid disease, spinal cord injuries, psych medications, paralyzing agents, current values against patient’s normal

Range Value
Normal 36.5 – 37.5 °C
Hypothermia < 35.0 °C
Hyperthermia / Fever > 37.5 – 38.3 °C
Hyperpyrexia > 40.0 – 41.5 °C

 

REFERENCES

Human Anatomy & Physiology 9th Edition 2011 by E N Marieb

Physical Examination & Health Assessment 6th Edition 2011 by C. Jarvis

 

More reading

GENERAL ASSESSMENT

PRIMARY ASSESSMENT

SECONDARY ASSESSMENT

KNOWLEDGE ADJUNCTS

AUSCULTATION SKILLS

RRS / MET VALUES

ASSESSMENT PRACTICE TOOL