The Vital Nature of Vital Signs: What Medical Assistants Need to Know About Monitoring Patients

Medical assistants (MAs) are the healthcare world’s jacks-of-all-trades. These trusted professionals do it all: answer phones, make appointments, update medical histories, and — perhaps most importantly — help patients feel more confident and comfortable. In addition, many are tasked with clinical responsibilities in the interest of streamlining healthcare processes and workflows and keeping entire facilities running smoothly. One of their most valuable clinical contributions? Taking vital signs.

While not all MAs serve in a clinical capacity, it is still meaningful to gain a well-rounded understanding of the many clinical tasks that play into the profession. Vital signs, in particular, are central to the role of the modern MA. This is one of the foundational topics covered when pursuing a Medical Assisting Certificate of Achievement, with mastery also crucial for securing credentials like the Certified Clinical Medical Assistant.

To that end, we’ve provided a detailed guide to vital signs as they relate to medical assisting. Keep reading for answers to key questions, such as: What are the vital signs, and why do they matter? Along the way, you will learn how you can master these skills through targeted medical assistant training.

What Are Vital Signs and Why Are They Important?

Vitals are a central component of every medical appointment, and yet, a typical patient might struggle to answer the seemingly simple query: What is a vital sign? In Vital Sign Assessment, this is defined as an “objective measurement of the essential physiological functions of a living organism.” This resource goes on to explain that measuring and assessing vital signs represents a “critical first step for any clinical evaluation.”¹

Although many important measurements are available that do not technically qualify as vital signs, those that make the cut are typically completed because they are so easy to obtain and understand. With limited training, many types of healthcare professionals can master these skills and provide almost instantaneous insight into the current condition of any given patient.

While there is some disagreement about what exactly constitutes a vital sign, most lists of examples typically include the following:

• Body temperature – Simple to track yet highly insightful, body temperature represents a key metric that can be taken before patients even enter healthcare facilities. Though this on its own will not provide any definitive answers about a patients’ condition, it is indicative of many acute illnesses and even some chronic conditions. Temperature is also frequently used to establish a baseline, particularly for patients about to undergo invasive procedures. A sudden increase in temperature may indicate infection or other issues.
• Peripheral oxygen saturation – As a noninvasive measure of respiratory function, peripheral oxygen saturation is expressed as the percentage of oxygenated hemoglobin present within the patient’s blood. This reveals “how much hemoglobin is currently bound to oxygen compared to how much hemoglobin remains unbound” and, according to medical experts, “is an essential element in the management and understanding of patient care.”²
• Respiratory rate – Often simply referred to as the patient’s breathing rate, this vital sign can be influenced by many factors, ranging from physical conditions (such as pneumonia or cardiac issues) to emotional concerns like anxiety. Respiration rates may also increase in response to exercise or extreme heat or cold. Tracking this vital sign is simply a matter of observing the patient and counting the number of breaths for a full minute.
• Blood pressure – Reflecting how powerfully patients’ blood travels within (and pushes against the walls of) their blood vessels, blood pressure can be a helpful sign for tracking cardiac concerns. Neha Sachdev, MD, tells the American Medical Association (AMA) that “high blood pressure raises [the] risk for serious events like a heart attack or a stroke,” adding that, if this problem is spotted early, patients and doctors can work together to implement strategies that reduce the likelihood of cardiac events and other serious health concerns. This vital sign actually involves two categories: systolic (representing the pressure on the arteries while the heart is beating) and diastolic (tracking the pressure on the arteries between heartbeats).
• Heart rate – Also known as the patient’s pulse, resting heart rate involves the number of beats per minute. This can vary significantly from one patient to the next and may even change with age or other life adjustments. It is another vital sign that can be measured with simple counting, this time by tracking the pulsations of the arteries in the wrist or neck. When MAs measure heart rate, they count the number of pulsations that occur within a 15-second span and then multiply the results by four.

Other health indicators — although not officially deemed vital signs — are becoming more prominent and may enter this classification in the near future. Many experts argue, for example, that blood glucose should be deemed a vital sign given the current prominence of diabetes and especially because there is evidence that elevated blood glucose in non-diabetic patients can lead to negative outcomes when hospitalization is necessary.

How Does a Medical Assistant Take Vital Signs?

Medical assistants rely on a variety of tools, devices, and equipment to gather vital signs. Some, as discussed, can be tracked by observing patients while counting pulsations or respirations, but many others call for the strategic application of common clinical devices. Familiar examples include:

• Blood pressure cuff – A device known as a sphygmomanometer (more frequently called a blood pressure cuff) can be used to obtain blood pressure readings. When MAs are involved, this typically means placing the cuff at the patient’s upper arm while placing a stethoscope over the brachial artery. While electronic readings are increasingly used, manual readings remain the gold standard for modern medical care.
• Thermometers – Familiar to patients and MAs, thermometers measure body temperature. MAs use clinical-grade thermometers to achieve more accurate results. These days, infrared solutions are popular because they limit the need for contact. However, MAs should be familiar with several strategies and devices and capable of taking patients’ temperatures in a way that delivers the greatest comfort, cooperation, and accuracy possible.
• Pulse oximeters – Peripheral oxygen saturation is best measured via noninvasive devices known as pulse oximeters. These can be easily placed on patients’ fingertips. Oxygen levels impact how well beams of light sent by the oximeter are absorbed. Combined with concerning signs or symptoms, oximeter readings may be indicative of hypoxia or simply suggest that a patient’s lungs are not working optimally.

Many healthcare professionals are authorized to take vital signs, but this task is progressively handled by MAs in hopes of streamlining other essential processes for nurses and clinical employees. As such, it is crucial that medical assistants (especially those primarily employed in a clinical capacity) understand how to take vitals on a patient.

How Are Vital Signs Recorded?

Once each vital sign has been observed and analyzed, medical assistants must enter these metrics into their patients’ records. These days, these are typically added to electronic health records (EHRs), which can be leveraged over time to provide greater awareness of patients’ current health conditions and how this evolves over time.

Strategies for recording should aim for accuracy, but prompt record-keeping is also key. Research published in the Journal of Clinical Nursing reveals a great deal of variability in vital sign workload, especially as this relates to record-keeping. In general, however, “documenting vital signs observations electronically at the bedside [is] faster than documenting vital signs away from the bed,” so mobile solutions are increasingly preferred.⁴

In an effort to improve workflows, many facilities have begun implementing wearable devices that, according to the International Journal of Environmental Research and Public Health, connect “wirelessly to a monitor and the electronic patient record.” Systems highlighted in this publication import vital signs to the EHR every minute, adding that “a visible and audible alarm from the remote monitor indicates when vital signs deviate.”⁵

What Do Vital Signs Tell the Medical Assistant?

Although medical assistants are responsible for collecting and documenting vital signs, it is not their role to interpret or discuss them with patients. Still, MAs should be aware of results when measuring vital signs, as they can alert nurses or physicians when they suspect that current vital signs are cause for concern. In general, MAs should pay attention to these concerns:

Looking for Abnormal Vital Signs

Vital signs can provide an immediate indication that something is wrong with the patient. Issues uncovered by vital signs are not always readily observed — blood pressure, for instance, may be alarmingly high even when patients appear perfectly normal. If unusual metrics are observed, MAs should alert other medical professionals, who may use these details alongside other tests or assessments to make diagnoses.

MAs should have a basic understanding of what constitutes “abnormal” vital signs. According to guidelines from the American Heart Association (AHA),⁶ signs for concern might include:

• Systolic blood pressure (SBP) less than 90 mm Hg or exceeding 130 mm Hg
• Diastolic blood pressure (DBP) less than 60 mm Hg or exceeding 80 mm Hg
• Pulse rate less than 60 per minute or exceeding 100 per minute
• Temperature less than 95 °F or exceeding 99.6 °F
• Blood oxygen level less than 95 percent

When vital signs are approaching these levels, there may still be cause for concern. At this point, the levels may not be officially defined as abnormal, but clinical professionals should remain mindful of significant changes or vital signs consistently near abnormal levels.

Detecting Illness

From the home to the hospital and everywhere in between, a variety of people use vital signs to gain insight into acute illnesses. The thermometer, for example, is the go-to tool for parents worried about their children contracting fevers.

Similarly, MAs rely on vital signs to provide early indications of infection, which can later be confirmed by different, more targeted tests. Without vital signs, however, MAs and other healthcare workers may never know that these additional tests are necessary in the first place.

Body Mass Index (BMI)

Body mass index acts as a simple screening tool, revealed by comparing and contrasting height and weight. In children, the ensuing calculation can provide insight for growth charts. The specific manifestations of BMI can also be helpful; height, for example, may reveal osteoporosis or other age-related concerns, while changes in weight could reflect malnourishment or obesity, which can be deemed a risk factor for many chronic conditions.

Overall Look at the Patient’s Health

While there is more to each patient’s story than vital signs alone can tell, these often provide an excellent summary or, at least, a starting point that might encourage clinical professionals to take a closer look. No one vital sign will necessarily provide extensive insight, but certain patterns may emerge as these are analyzed together.

For example: If blood pressure rates trend up alongside BMI (especially as patients report smoking or insufficient exercise), medical professionals can provide targeted recommendations for advisable lifestyle adjustments, along with preventive solutions (such as beta blockers or ACE inhibitors) as necessary. Even for patients in excellent health, vital signs can act as a helpful baseline to confirm desirable health status and serve as a point of comparison if patients later visit facilities with significant medical complaints.

Determining Treatment Impact

As vital signs are tracked over time, healthcare professionals can determine whether treatment plans are having their intended effect. Should vital signs remain equally concerning (or grow worse), it will be abundantly clear that another strategy is necessary. However, if these numbers begin to improve, this may indicate that treatment plans are going well. Among hospitalized patients in particular, vital signs provide a clear indication of patient status and can even predict clinical deterioration among those suffering from acute illnesses.

It is now easier to monitor patient vital signs in the long term with help from at-home solutions such as smart thermometers and blood pressure monitoring systems. Patients involved in remote monitoring programs can track these and other metrics at home, with measurements sent to clinics via mobile devices. Additionally, research published in the Journal of General Internal Medicine suggests that vital sign tracking upon discharge may reveal when extra caution is warranted — or whether at-risk patients might be better served by post-acute care facilities.⁷

No matter where or how vital tracking takes place, MAs can play a helpful role by educating patients and streamlining workflows. Their contributions ensure clinical professionals at all levels are fully informed so that patients receive the targeted care and accurate information they deserve.

Prepare for a Career in Medical Assisting

Learn how to perform tasks like taking vital signs by training to become a Medical Assistant at Carrington College.

Sources

1. Sapra, A, et al. “Vital Sign Assessment.” National Library of Medicine.
2. Hafen, B, et al. “Oxygen Saturation.” National Library of Medicine.
3. Berg, S. “What doctors wish patients knew about high blood pressure.” American Medical Association.
4. Dall-Ora, C, et al. “What is the nursing time and workload involved in taking and recording patients’ vital signs? A systematic review.” Journal of Clinical Nursing.
5. Becking-Verhaar, S, et al. “Continuous Vital Signs Monitoring with a Wireless Device on a General Ward: A Survey to Explore Nurses’ Experiences in a Post-Implementation Period.” International Journal of Environmental Research and Public.
6. “Understanding Blood Pressure Readings.” American Heart Association.
7. Nguyen, O, et al. “Vital Signs Are Still Vital: Instability on Discharge and the Risk of Post-Discharge Adverse Outcomes.” Journal of General Internal Medicine.