True vital signs

In the UK the following have been considered best practice for some time now.  SNOMED CT currently has Heart rate as a subtype of pulse, when the pulse is actually an indication of heart rate detectable at the central or peripheral pulse.  

I am not sure what other measures of levels of consciousness are used worldwide, the only one I know of in widespread use in adults  is Glasgow Coma Scale.  There are some paediatric and ventilatory variants but most seem to be based on this scale.

Definition of pulse

1. 1a  :  the regular expansion of an artery caused by the ejection of blood into the arterial system by the contractions of the heartb  :  the palpable beat resulting from such pulse as detected in a superficial artery; also  :  the number of individual beats in a specified time period (as one minute) <a resting pulse of 70>

   http://www.merriam-webster.com/dictionary/pulse

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(National Institute for Health and Care Excellence)

1.2 As a minimum, the following physiological observations should be recorded at the initial assessment and as part of routine monitoring:

• heart rate

• respiratory rate

• systolic blood pressure

• level of consciousness

• oxygen saturation

• temperature.

https://www.nice.org.uk/guidance/CG50/chapter/1-Guidance

The question is whether the various site specific concepts should be included.  So long as modelled appropriately then there should be few issues, but there are a large number of the values that if trended would not be comparable unless against the specific concept.  This is particularly the case with blood pressures where many of the values would be completely misleading and I am not sure the inheritance is appropriate. A GP recording 120/80 against 75367002 | Blood pressure (observable entity) is hardly comparable with the subtype 118433006 | Pulmonary artery wedge pressure (observable entity) which might be recorded in Intensive Care

Hi, the U.S. Federal Health Information Modeling (FHIM) group would like to contribute to this effort but we are not sure what the exact "ask" is. Are you asking what the basic observations are (e.g. systolic, diastolic, etc.) or are you also interested in the qualifiers (e.g. body position, cuff size, etc.). Thanks...Susan

Hi Susan,

the specific question asked here is what the more specific vital signs are. The current representation where all body temperatures are vital signs, by inheritance, makes finger temperature a vital sign. If possible, the vital signs (primitive) concept could be further specified to only subsume observables which are always vital signs, e.g. core body temperature observables.

/Daniel