This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (3)  • Contact me when this article is cited  Related Content  • Related letters  • Related article  • Similar articles in this journal  Topic Collections  • Aging/ Geriatrics  • Law and Medicine  • Pain  • Pediatric Surgery  • Surgical Physiology, Other  • Diagnosis  • Drug Therapy  • Adverse Effects  • Alert me on articles by topic  Social Bookmarking   What's this?

Robert A. Kozol, MD; Anthony Voytovich, MD

Arch Surg. 2007;142(5):417-419.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The traditional quartet of vital signs (pulse, blood pressure, temperature, and respiration) has always played a prominent role in the diagnostic armamentarium and remains, appropriately, at the head of the written or verbally presented physical examination. The earliest manifestations of infection, sepsis, occult bleeding, and cardiopulmonary dysfunction often become apparent when looking at the vital signs. In the case of a patient with a high spinal cord injury and autonomic dysreflexia, profound hypertension and bradycardia may be the only clue to a medical or surgical crisis that otherwise remains silent because of interrupted pain pathways.

Despite their value, these trusted measurements have always had their pitfalls and limitations. Blood pressure readings can be misleading because of measurement variation and error inherent in improper cuff width, auscultatory gap (the silent phases between systolic and diastolic determinations), and even the auditory acuity of the listener, . . . [Full Text of this Article]

AUTHOR INFORMATION


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED LETTERS

Pain as the Fifth Vital Sign
Paul Rousseau
Arch Surg. 2008;143(1):98.
EXTRACT | FULL TEXT  

Pain Assessment Is Vital
Betty Ferrell
Arch Surg. 2008;143(1):98-99.
EXTRACT | FULL TEXT  

Pain Assessment Is Vital—Reply
Robert Kozol and Anthony Voytovich
Arch Surg. 2008;143(1):99.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Misinterpretation of the Fifth Vital Sign—Invited Critique
Edward H. Livingston
Arch Surg. 2007;142(5):419-420.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Pain as the Fifth Vital Sign
Rousseau
Arch Surg 2008;143:98-98.
FULL TEXT  

Pain Assessment Is Vital
Ferrell
Arch Surg 2008;143:98-99.
FULL TEXT  

The Role of Opioids in Pain Management
White and Kehlet
Anesth. Analg. 2007;105:1866-1866.
FULL TEXT