Vital Sign Measurement Across the Lifespan - 1st Canadian Edition

April 12, 2018 | Updated: January 30, 2021
Author: Jennifer L. Lapum, Margaret Verkuyl, Wendy Garcia, Oona St-Amant, Andy Tan, Ryerson University

Good news! This book has been updated and revised. An adaptation of this book can be found here:

THIS BOOK WILL BE ARCHIVED ON JUNE 1, 2021, AS IT HAS BEEN REPLACED BY A NEW EDITION. The purpose of this textbook is to help learners develop best practices in vital sign measurement. Using a multi-media approach, it will provide opportunities to read about, observe, practice, and test vital sign measurement.

Subject Areas
Health and Medical, Health/Medical - General

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Vital Sign Measurement Across the Lifespan - 1st Canadian Edition by Jennifer L. Lapum, Margaret Verkuyl, Wendy Garcia, Oona St-Amant, Andy Tan, Ryerson University is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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Reviews (1) Avg: 4.9 / 5

Renée Anderson

Institution:Thompson Rivers UniversityTitle/Position: Senior LecturerCreative Commons License

Q: The text covers all areas and ideas of the subject appropriately and provides an effective index and/or glossary

The text does not include an index / glossary
The text is comprehensive. Having short chapters with easily readable text, appealing photos, short videos and a variety of self assessment methods are effective pedagogies and I believe will appeal to the learner.

The text includes sectioned titled ‘Try it Out’ and ‘Test Yourself’. These are excellent opportunities for students to visualize what they are trying to learn and opportunities for them to do self assessment of their learning. Inclusion of videos into these sections add quality to this resource

Comprehensiveness Rating: 5 out of 5

Q: Content is accurate, error-free and unbiased

The text mainly refers to two other OER resources. I am familiar with one of them: Reese Doyle, G and McCutcheon, J. (2015) .Clinical Procedures for Safer Patient Care by British Columbia Institute of Technology (BCIT) is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted. and know it to be a high quality resource.

Otherwise the reference list is relatively short. As a content expert, I know the content to be accurate. From an academic perspective, and from the messaging to students that is reinforced in the resources we ask them to use, material should be referenced accordingly, I have suggestions for inclusion of more referencing.

Chapter 1: Introduction
Section: General Points to Consider in Vital Sign Measurement:
Under ‘Points to Consider’ suggest to change ‘hand gel’ to alcohol based hand rub (ABHR) and include a reference to support its use in hand hygiene. Source: Center for Disease Control and Prevention (2020). Hand Hygiene Guidance.
Under ‘Pain Assessment’ suggest including reference for pain assessment tool ‘PQRST’

Chapter 2: Temperature
Section: Methods of Measurement:
Suggest including a reference for ‘The most accurate way to measure core body temperature is an invasive method through a pulmonary artery catheter’

Section: ‘Test Yourself: List in the Correct Order – Answers
In the chapter it says ‘These are printable flashcards to help you memorize and practice the techniques’ . How is the printable flashcard feature supposed to work?

Chapter 3: Pulse and Respiration
Section: What Pulse Qualities are Assessed?
Suggest including a reference for the ‘Pulse Force - 4 point scale’

In ‘Pulse Equality' paragraph, suggest clarity to the statement ‘the carotid pulses should never be palpated at the same time ‘I think you mean ‘both carotid pulses should never be palpated at the same time….’ suggest including a reference

Section: Radial Pulse under ‘Points to consider’. Suggest including a reference for the Doppler

Chapter 4: Oxygen Saturation
Section: What is Oxygen Saturation? Suggest including a reference after that paragraph.

Section: ‘Points to Consider’ suggest including a reference after first sentence in first paragraph.

Chapter 5: What is Blood Pressure?
The analogy of turning on the kitchen tap at different rates to simulate BP is excellent. Suggest including a reference for stroke volume (paragraph 3) and pulse pressure (paragraph 4)

Section: What are Normal Blood Pressure Ranges? Suggest a reference for ‘table 5.1’’, Factors that influence blood pressure’ and ‘white coat syndrome’

Section: How is Blood Pressure Measured? In paragraph titled ‘Technique Tips’ suggest a reference for ‘the thigh systolic blood pressure is 10-40 mm Hg higher than the arm systolic blood pressure’

Under Points to Consider: Suggest reference for ‘it is best to also complete a manual blood pressure measurement to validate the accuracy of the automatic blood pressure measurement’. I know we do this in practice, I challenge why we might not use a different automatic machine to validate BP. I wonder if verifying with a manual cuff is one of those things ‘we always do’ but is there actually no evidence to support our habit.

Section: Manual Blood Pressure Measurement… suggest that in the first paragraph discussion of ‘the maximum inflation pressure…’ has the same reference that is found later in the Two Step Technique section…in other words, the same reference in two places.

Suggest including a reference for ‘auscultatory gap’ in paragraph 2.

Section: Test yourself. These are excellent questions. In particular including a question about BP in pregnancy reinforces the importance of considerations across the lifespan.

Chapter 6: Knowledge Integration
General comments: providing case studies across the lifespan is an excellent opportunity for learners to begin understanding variability in vitals across the lifespan and across different health contexts. Having the learner document vital signs is excellent pedagogy and a skill many of them struggle with. The case studies could be integrated into curriculums at different points as the student’s understanding of pathophysiology grows.
Case Study 1: Adult Client (continued) (1st in the list): I think it is excellent that you pose the question ‘What infection control measures should the health care provide implement?’ The answer will depend of the setting. If in an emergency department / hospital the answer should be Contact Precautions which goes beyond hand washing.

Case Study 1: Adult Client (continued) (2nd in the list). Integration of pulse quality into the case study requires the learner to integrate previously learned material. Pulse quality is not documented on most vital signs sheets. As such this reinforcement of previously learned material is excellent pedagogy.

Case study 1: Adult Client (continued) (3rd in the list). Question: Which findings are considered abnormal for this adult client? What medical terminology is used to define / label these findings? Answer should also include: Temperature 37.9 (tympanic) is considered elevated. The person appears to have a fever.

Case Study 2: Pediatric Client (continued) (2nd on the list). Suggest a reference / resource for bullet point referring to febrile seizures. Learners just beginning to take vital signs may not know that this refers to.

Content Accuracy Rating: 5 out of 5

Q: Content is up-to-date, but not in a way that will quickly make the text obsolete within a short period of time. The text is written and/or arranged in such a way that necessary updates will be relatively easy and straightforward to implement


Relevance Rating: 5 out of 5

Q: The text is written in lucid, accessible prose, and provides adequate context for any jargon/technical terminology used

Having short chapters with easily readable text I believe will appeal to the learner.

Clarity Rating: 5 out of 5

Q: The text is internally consistent in terms of terminology and framework


Consistency Rating: 5 out of 5

Q: The text is easily and readily divisible into smaller reading sections that can be assigned at different points within the course (i.e., enormous blocks of text without subheadings should be avoided). The text should not be overly self-referential, and should be easily reorganized and realigned with various subunits of a course without presenting much disruption to the reader.

This is a strength of this text. Sections are short. Titles are organized and titled clearly

Modularity Rating: 5 out of 5

Q: The topics in the text are presented in a logical, clear fashion

Each chapter has multiple sections, each building on the other. Each chapter wraps up with activities to reinforce the material.

Organization Rating: 5 out of 5

Q: The text is free of significant interface issues, including navigation problems, distortion of images/charts, and any other display features that may distract or confuse the reader

My only confusion was in the Chapter titled Conclusion. There is a section 'Printable Flashcards'. I expected a feature that I could ‘click’ and flashcards would print. What I see is a list of steps that I could put onto flashcards myself. Maybe this is an issue with my computer? Or maybe more explicit instructions are necessary.

Interface Rating: 4 out of 5

Q: The text contains no grammatical errors

Grammar and spelling are free of errors

Grammar Rating: 5 out of 5

Q: The text is not culturally insensitive or offensive in any way. It should make use of examples that are inclusive of a variety of races, ethnicities, and backgrounds

A strength of the text is particularly in Chapter 6: Knowledge Integration where learners are presented with somewhat unfolding case studies across the lifespan (adult client, pediatric client, pregnant client, older adult client)

Cultural Relevance Rating: 5 out of 5

Q: Are there any other comments you would like to make about this book, for example, its appropriateness in a Canadian context or specific updates you think need to be made?

Yes I would. However from an academic perspective I think inclusion of more references would strengthen the appearance of rigor.