moistness   or   dryness,   can   also   be   conveniently determined at this time. Pulse.—When taking a patient’s pulse, you should be concerned with two factors:  rate and character.  For pulse rate, you will have to determine the number of beats per minute.    Pulse rate is classified as normal, rapid,   or   slow. A  normal   pulse   rate   for   adults   is between  60  to  80  beats  per  minute.    Any  pulse  rate above  100  beats  per  minute  is  rapid  (tachycardia), while   a   rate   below   60   beats   per   minute   is   slow (bradycardia). NOTE:   An athlete may have a normal at-rest pulse   rate   between   40   and   50   beats   per minute.  This is a slow pulse rate, but is not an indication of poor health. Pulse  character  is  the  rhythm  and  force  of  the pulse. Pulse   rhythm   is   evaluated   as   regular   or irregular.   When intervals between beats are constant, the   pulse   is   regular,   and   when   intervals   are   not constant,  the  pulse  is  described  as  irregular. Pulse force   refers  to  the  pressure  of  the  pulse  wave  as  it expands the artery.  Pulse force is determined as full or thready.    A full  pulse  feels  as  if  a  strong  wave  has passed  under  your  fingertips.    When  the  pulse  feels weak and thin, the pulse is described as thready. The pulse rate and character can be determined at a number  of  points  throughout  the  body. The  most common   site   to   determine   a   patient’s   pulse   is   the radial pulse.   The radial pulse (wrist pulse) is named after the radial artery found in the lateral aspect of the forearm. Respiration.—Respiration is the act of breathing. A single breath is the complete process of breathing in (inhalation) followed by breathing out (exhalation). When   observing   respiration   in   connection   to   vital signs, you should be concerned with two factors:  rate and character. Respiration rate is the number of breaths a patient takes in 1 minute.   The rate of respiration is classified as normal, rapid, or slow.  The normal respiration rate for an adult at rest is 12 to 20 breaths per minute.   A rapid respiration rate is more than 28 respirations per minute,  and  a  slow  respiration  rate  is  less  than  10 breaths per minute.    A rapid or slow respiration rate indicates the patient is in need of immediate medical attention   and   should   be   transported   to   a   medical treatment facility as soon as possible. Respiration  character   includes  rhythm,  depth, ease  of  breathing,  and  sound. Respiration  rhythm refers   to   the   manner   in   which   a   person   breathes. Respiration rhythm is classified as regular or irregular. A regular rhythm is when the interval between breaths is   constant,   and   an   irregular   rhythm   is   when   the interval between breaths varies. Respiration  depth   refers  to  the  amount  of  air moved  between  each  breath. Respiration  depth  is classified as normal, deep, or shallow. Ease  of  breathing  can  be  judged  while  you  are judging  depth.    Ease  of  breathing  may  be  judged  as labored, difficult, or painful. Sounds   of   respiration    include    snoring , wheezing,   crowing   (birdlike  sounds),  and   gurgling (sounds like breaths are passing through water). You should count respirations as soon as you have determined the pulse rate. Count the number of breaths taken by the patient during 30 seconds and multiply by 2  to  obtain  the  breaths  per  minute.    While  you  are counting  breaths,  note  the  rhythm,  depth,  ease  of breathing, and sounds of respiration. Blood Pressure.—The measurement of the pressure blood exerts against the wall of blood vessels is known as blood pressure. The pressure created in the arteries when the heart pumps blood out into circulation (heart beat) is called  the   systolic   blood  pressure. The  pressure remaining  in  the  arteries  when  the  heart  is  relaxed (between beats) is called the  diastolic  blood pressure. The  systolic  pressure  is  always  reported  first  and  the diastolic pressure second (e.g., 120 over 80). Blood pressure varies from one person to another and is measured with a stethoscope and a sphygmomanometer  (BP cuff).    Low  blood  pressure (hypotension) is considered to exist when the systolic pressure falls below 90 millimeters of mercury (mm Hg) and/or the diastolic falls below 60.   “Millimeters of mercury”  refers to the units of the BP cuff’s gauge. High  blood  pressure  (hypertension)  exists  once  the pressure rises above 150/90 mm Hg. Keep in mind that patients may exhibit a temporary rise in blood pressure during emergency situations.   More than one reading will be necessary to determine if a high or low reading is only temporary.  If a patient’s blood pressure drops, the patient may be going into shock. You should report major   changes   in   blood   pressure   immediately   to medical facility personnel. Te m p e r a t u re . — B o d y     t e m p e r a t u r e s     a r e determined by the measurement of oral, rectal, axillary 4-10