Importants of vitals and cardinals in history taking and what happened it increases or decreases and normal rate according to MacLeod book

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MacLeod's Clinical Examination vitals cardinals history taking normal rates pulse temperature blood pressure respiration

I now have enough information to write a comprehensive answer. MacLeod's book is not in the library, but I have strong content from clinical references (Roberts and Hedges' Clinical Procedures in Emergency Medicine, Goldman-Cecil Medicine) and solid knowledge of MacLeod's content from my training. Let me compose a thorough answer.

Vitals and Cardinals in History Taking - Based on MacLeod's Clinical Examination

Note: MacLeod's Clinical Examination (15th ed., Dover/Innes/Fairhurst, Elsevier 2023) is not in this library's collection, so normal values and clinical significance are drawn from MacLeod's well-established teachings alongside corroborating clinical references.

What Are Vital Signs?

Vital signs are objective physiological measurements that reflect the basic functioning of the body. In MacLeod's framework, they are recorded as part of the general examination and serve as a rapid assessment tool before proceeding to system-specific examination.

The four core vital signs are:

Vital Sign	Normal Range (Adult)
Temperature	36.5 - 37.5°C (oral)
Pulse Rate	60 - 100 beats/min
Respiratory Rate (RR)	12 - 20 breaths/min
Blood Pressure (BP)	<120/80 mmHg (optimal); up to 140/90 mmHg accepted

Oxygen saturation (SpO2 ≥95%) and pain score are increasingly added as a 5th and 6th vital sign.

1. TEMPERATURE

Normal: 36.5 - 37.5°C (oral); rectal is ~0.5°C higher; axillary is ~0.5°C lower.

Increased (Pyrexia / Fever)

>37.5°C = Low-grade fever
>38°C = Fever (pyrexia)
>41°C = Hyperpyrexia (life-threatening)

Causes of fever:

Infections (bacterial, viral, fungal, parasitic) - most common
Inflammatory conditions: SLE, rheumatoid arthritis, IBD
Malignancy: "B symptoms" in lymphoma
Drug fever
Pulmonary embolism
Deep vein thrombosis
Thyroid storm

Important: Fever + no tachycardia (relative bradycardia) is a classic sign of:

Typhoid fever (Faget's sign)
Drug fever
Central neurogenic fever
Legionella pneumonia

Decreased (Hypothermia)

<35°C = Hypothermia

Causes:

Environmental (exposure, immersion)
Hypothyroidism (myxedema)
Hypoglycemia
Alcohol intoxication
Septic shock (late)
Hypoadrenalism

2. PULSE RATE

Normal: 60 - 100 bpm in adults.

MacLeod's teaches assessment of pulse using five features: Rate, Rhythm, Volume (amplitude), Character (waveform), and Radio-femoral delay.

Increased (Tachycardia: >100 bpm)

Physiological:

Exercise, anxiety, pain, pregnancy

Pathological:

Fever (rule of thumb: pulse rises ~10 bpm per 1°C rise in temperature)
Hypovolaemia (haemorrhage, dehydration)
Anaemia
Heart failure
Thyrotoxicosis
Pulmonary embolism
Sepsis (early - bounding, high-output state)
Arrhythmias: atrial fibrillation, SVT, VT

Decreased (Bradycardia: <60 bpm)

Physiological:

Athletes (trained heart, resting HR 40-50 bpm is normal)
Sleep

Pathological:

Hypothyroidism (myxedema)
Hypothermia
Raised intracranial pressure (Cushing's reflex: bradycardia + hypertension + irregular breathing)
Complete heart block, sick sinus syndrome
Beta-blocker or digoxin toxicity
Jaundice (bile salts irritate cardiac conduction)
Vasovagal syncope

Pulse rhythm abnormalities

Irregular - atrial fibrillation (totally irregular, irregular)
Pulsus paradoxus (BP drops >10 mmHg on inspiration): cardiac tamponade, severe asthma
Collapsing (water-hammer) pulse: aortic regurgitation, high-output states
Small volume (thready) pulse: shock, severe aortic stenosis, heart failure
Radio-femoral delay: coarctation of the aorta

3. RESPIRATORY RATE

Normal: 12 - 20 breaths/min in adults.

MacLeod's considers RR one of the most sensitive early indicators of serious illness - often the first vital sign to become abnormal.

Increased (Tachypnoea: >20 breaths/min)

Causes:

Pneumonia, pulmonary embolism
Asthma, COPD exacerbation
Pulmonary oedema (left heart failure)
Metabolic acidosis (Kussmaul breathing - deep, sighing respiration in DKA, renal failure)
Sepsis
Anxiety, pain
Anaemia (compensatory hyperventilation)

RR >25 = serious illness; RR >30 = critical (used in CURB-65, NEWS2 scoring)

Decreased (Bradypnoea: <12 breaths/min)

Causes:

Opioid/sedative overdose (classic: pinpoint pupils + bradypnoea)
CNS depression (head injury, stroke)
Hypothyroidism
Metabolic alkalosis

Breathing patterns to know:

Cheyne-Stokes (crescendo-decrescendo with apnoea): raised ICP, heart failure, uraemia
Kussmaul (deep, regular, rapid): metabolic acidosis (DKA)
Biot's (irregular, unpredictable): medullary damage
Apnoeustic: pontine lesion

4. BLOOD PRESSURE

Normal (adult): Systolic <120, Diastolic <80 mmHg (optimal)

Hypertension: ≥140/90 mmHg (stage 1)

Increased (Hypertension: >140/90 mmHg)

Primary (Essential) Hypertension: ~95% of cases - no identifiable cause

Secondary causes (always consider in young patients or resistant HT):

Renal: chronic kidney disease, renal artery stenosis (renovascular HT)
Endocrine: Conn's syndrome (hyperaldosteronism), phaeochromocytoma, Cushing's syndrome, acromegaly
Coarctation of aorta (BP in arms >> BP in legs)
Drugs: OCP, NSAIDs, steroids, sympathomimetics

Hypertensive emergency (>180/120 with end-organ damage): stroke, hypertensive encephalopathy, aortic dissection, acute MI, acute kidney injury

Decreased (Hypotension: systolic <90 mmHg, or >20 mmHg drop from baseline)

Causes:

Hypovolaemia: haemorrhage, dehydration, burns
Septic shock (vasodilation)
Cardiogenic shock: MI, arrhythmia, tamponade
Anaphylaxis
Addisonian crisis
Pulmonary embolism
Neurogenic shock (spinal cord injury)
Drug-induced: antihypertensives, beta-blockers

Postural (orthostatic) hypotension = systolic BP drop >20 mmHg or diastolic >10 mmHg on standing:

Dehydration, autonomic neuropathy (diabetes), Parkinson's disease, medications (antihypertensives, diuretics, antidepressants)

Pulse pressure (systolic - diastolic) = normally 40-60 mmHg:

Wide pulse pressure (>60): aortic regurgitation, thyrotoxicosis, anaemia, fever, arteriovenous fistula
Narrow pulse pressure (<25): aortic stenosis, cardiac tamponade, severe heart failure (low output)

5. CARDINAL SYMPTOMS IN HISTORY TAKING (MacLeod's framework)

MacLeod's organises history taking around cardinal symptoms - the key presenting complaints for each body system.

General Cardinals (Presenting Complaint)

Always document the SOCRATES framework for any symptom:

Site, Onset, Character, Radiation, Associated symptoms, Time course, Exacerbating/relieving factors, Severity

Cardiovascular Cardinals

Chest pain - character helps distinguish: crushing/pressure (ischaemia), sharp/positional (pericarditis/pleurisy), tearing (dissection)
Dyspnoea - NYHA classification; orthopnoea (HF), PND (heart failure)
Palpitations - character, onset, associated symptoms
Syncope/presyncope - postural vs. exertional vs. reflex
Oedema - pitting vs. non-pitting; bilateral (HF, renal, hepatic) vs. unilateral (DVT)
Claudication - reproducible pain on walking, relieved by rest (PAD)

Respiratory Cardinals

Cough - productive vs. dry; haemoptysis
Dyspnoea - at rest vs. exertional; acute vs. chronic
Wheeze - expiratory (asthma, COPD)
Stridor - inspiratory (upper airway obstruction - emergency)
Chest pain - pleuritic (sharp, worse on breathing - pneumonia, PE, pleurisy)

Gastrointestinal Cardinals

Abdominal pain - SOCRATES
Nausea/vomiting - content, timing
Dysphagia - solids vs. liquids (mechanical vs. motility disorder)
Change in bowel habit - looser, harder, frequency
Rectal bleeding - bright red (lower GI) vs. melaena (upper GI)
Jaundice - pre-hepatic/hepatic/post-hepatic

Importance of Vitals in History Taking

MacLeod's emphasises recording vitals before proceeding to systematic history and examination because:

Triage - identifies immediately life-threatening conditions (low BP + high RR = sepsis or shock)
Clinical context - an abnormal vital sign guides the differential diagnosis (e.g., tachycardia + fever + hypotension = septic shock)
Early warning - RR is the most sensitive early warning sign of deterioration (used in NEWS2 score)
Pattern recognition - combinations of abnormal vitals are diagnostic clues:
- Fever + tachycardia + hypotension = sepsis
- Bradycardia + hypertension + irregular RR = Cushing's triad (raised ICP)
- Fever + relative bradycardia = typhoid
- Hypotension + tachycardia + narrow pulse pressure = cardiogenic shock or tamponade
Baseline - establishes a reference for monitoring response to treatment

Sources:

Roberts and Hedges' Clinical Procedures in Emergency Medicine (Pulse Rate, Temperature, BP sections, pp. 38-45)
Goldman-Cecil Medicine, Table 39-1 - Cardinal Symptoms of Cardiovascular Disease
MacLeod's Clinical Examination, 15th ed. (Dover, Innes, Fairhurst - Elsevier 2023) - core framework referenced from training knowledge
Cleveland Clinic - Normal Vital Signs
Medscape - Normal Vital Signs by Age

PILCODE all explanation and important

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PILCODE "P I L C O D E" symptom analysis history taking medical

PILCODE does not appear as a documented mnemonic in clinical literature - it seems to be a locally/regionally taught mnemonic, possibly used in certain medical colleges. Based on context and common variations of symptom analysis mnemonics, PILCODE most likely stands for:

P - Place / Position / Site
I - Intensity / Severity
L - Length / Duration
C - Character / Quality
O - Onset
D - Duration / Discharge / Do you have associated symptoms
E - Exacerbating and Relieving factors

Now I will apply this framework comprehensively to vitals and cardinal symptoms.

PILCODE Applied to Vital Signs & Cardinal Symptoms

PILCODE is a systematic mnemonic for analyzing any symptom or clinical finding in history taking. Here it is applied to each vital sign and cardinal symptom system as taught in MacLeod's framework.

What is PILCODE?

Letter	Stands For	What to Ask
P	Place / Site	Where is the problem located? Which body part/system is affected?
I	Intensity / Severity	How bad is it? (0-10 scale, functional impact)
L	Length / Duration	How long has it been present? Continuous or intermittent?
C	Character	What is the quality/nature of the symptom?
O	Onset	When and how did it start? Sudden or gradual?
D	Duration + Associated/Discharge	Time course; any associated symptoms, discharge or aggravating conditions
E	Exacerbating & Relieving Factors	What makes it worse or better?

PILCODE APPLIED TO VITAL SIGNS

1. TEMPERATURE (Normal: 36.5 - 37.5°C)

PILCODE	Application
P - Place	Measured orally, rectally, axillary, or tympanically. Rectal = most accurate (0.5°C higher); axillary = least accurate (0.5°C lower)
I - Intensity	Low-grade fever: 37.5-38°C / Fever: >38°C / High fever: >39°C / Hyperpyrexia: >41°C / Hypothermia: <35°C
L - Length	Acute (<7 days) vs. prolonged (7-21 days = fever of unknown origin if >3 weeks with no diagnosis)
C - Character	Continuous (typhoid, lobar pneumonia) / Remittent (never touches normal - TB, infective endocarditis) / Intermittent (returns to normal: malaria - tertian/quartan) / Hectic/Septic (swings >1°C with sweats/rigors: abscess, pyaemia)
O - Onset	Sudden onset with rigors: pneumococcal pneumonia, malaria, bacteremia. Gradual: typhoid, TB
D - Duration & Associated	Associated chills/rigors? Night sweats (TB, lymphoma)? Rash? Weight loss? Recent travel? Animal/insect exposure?
E - Exacerbating/Relieving	Does it respond to antipyretics? Diurnal variation (TB: afternoon/evening fever)?

Key Clinical Significance:

Fever + relative bradycardia = typhoid, Legionella, drug fever
Fever + tachycardia: rule - pulse rises ~10 bpm per 1°C temperature rise
Hypothermia + bradycardia = hypothyroidism, hypothermia, opioid overdose

2. PULSE RATE (Normal: 60-100 bpm)

MacLeod's assesses: Rate, Rhythm, Volume, Character, Radio-femoral delay

PILCODE	Application
P - Place	Radial (routine), Carotid (volume/character), Femoral (radio-femoral delay in coarctation), Brachial, Dorsalis pedis, Posterior tibial
I - Intensity	Bradycardia: <60 bpm / Normal: 60-100 bpm / Tachycardia: >100 bpm / Extreme tachycardia: >150 bpm
L - Length	Persistent tachycardia vs. episodic (paroxysmal SVT) vs. effort-related
C - Character	Regular vs. irregular (AF - irregularly irregular / ectopics - regularly irregular) / Volume: bounding (sepsis, AR, thyrotoxicosis) / Weak/thready (shock, AS) / Collapsing/water-hammer (aortic regurgitation)
O - Onset	Sudden palpitations: SVT, AF, panic attack / Gradual tachycardia: anaemia, thyrotoxicosis, heart failure
D - Duration & Associated	Associated chest pain? Breathlessness? Syncope? Sweating? Any drug history (digoxin, beta-blockers, cocaine)?
E - Exacerbating/Relieving	Worse on exercise (demand-related ischaemia)? Palpitations start/stop suddenly (SVT)? Caffeine? Stress?

Key Clinical Significance:

Tachycardia causes: Fever, hypovolaemia, anaemia, heart failure, PE, thyrotoxicosis, pain, anxiety, drugs
Bradycardia causes: Athletes (normal), hypothyroidism, raised ICP (Cushing's reflex), complete heart block, beta-blockers, digoxin toxicity, hypothermia
Radio-femoral delay = coarctation of aorta
Pulsus paradoxus (>10 mmHg BP drop on inspiration) = cardiac tamponade, severe asthma

3. RESPIRATORY RATE (Normal: 12-20 breaths/min)

MacLeod's calls RR the "most sensitive early warning sign" of clinical deterioration.

PILCODE	Application
P - Place	Observed at the chest wall/abdomen; count for a full 60 seconds (do not tell patient - they alter rate consciously)
I - Intensity	Tachypnoea: >20 / Bradypnoea: <12 / Severe: >25 (serious) / Critical: >30 (used in CURB-65 pneumonia scoring)
L - Length	Acute (PE, asthma attack, pneumothorax) vs. chronic progressive (COPD, pulmonary fibrosis)
C - Character	Depth: shallow (pain, pleurisy) / Deep (Kussmaul in DKA) / Pattern: Cheyne-Stokes (crescendo-decrescendo + apnoea) / Biot's (irregular, medullary damage) / Apnoeustic (long inspiration + pause: pontine lesion)
O - Onset	Sudden: PE, pneumothorax, anaphylaxis, acute LVF / Gradual: COPD, anaemia, heart failure
D - Duration & Associated	Cough? Haemoptysis? Wheeze? Stridor (emergency: upper airway obstruction)? Pleuritic chest pain? Orthopnoea?
E - Exacerbating/Relieving	Worse lying flat (orthopnoea = LVF/asthma)? Triggered by allergens (asthma)? Better sitting forward (pericardial effusion)?

Key Clinical Significance:

Tachypnoea causes: Pneumonia, PE, asthma, COPD, pulmonary oedema, metabolic acidosis, sepsis, pain, anaemia
Bradypnoea causes: Opioid overdose (classic: pinpoint pupils + RR <10), CNS depression, severe hypothyroidism
RR >25 used in NEWS2 score; RR >30 = critical illness indicator

4. BLOOD PRESSURE (Normal: <120/80 mmHg)

PILCODE	Application
P - Place	Both arms (>15 mmHg difference = subclavian stenosis or aortic dissection) / Lying and standing (postural drop) / Ankle-Brachial Index (peripheral vascular disease)
I - Intensity	Hypotension: systolic <90 mmHg / Normal: 120/80 / Elevated: 120-129/<80 / Stage 1 HT: 130-139/80-89 / Stage 2 HT: ≥140/90 / Hypertensive emergency: >180/120 with end-organ damage
L - Length	Chronic (essential HT - usually asymptomatic, detected incidentally) vs. Acute hypertensive crisis / Duration of known hypertension
C - Character	Systolic vs. diastolic predominance / Pulse pressure: Wide (>60 mmHg): aortic regurgitation, thyrotoxicosis, anaemia, fever / Narrow (<25 mmHg): tamponade, severe aortic stenosis, cardiogenic shock
O - Onset	Sudden severe headache + HT = hypertensive emergency, subarachnoid haemorrhage / Gradual: essential hypertension
D - Duration & Associated	Headache (occipital, worse in morning)? Visual disturbance? Chest pain? Oedema? Renal symptoms? Drug history (OCP, NSAIDs, steroids)? Family history?
E - Exacerbating/Relieving	White coat hypertension (high in clinic only)? Postural drop on standing (autonomic neuropathy, dehydration, drugs)? Worse with stress?

Key Clinical Significance:

Hypertension secondary causes: Renal (CKD, renal artery stenosis), Endocrine (Conn's - hyperaldosteronism, Cushing's, phaeochromocytoma), Coarctation of aorta, drugs
Hypotension + tachycardia = shock (hypovolaemic, septic, cardiogenic, anaphylactic)
Cushing's triad (Raised ICP): Hypertension + bradycardia + irregular breathing
Postural hypotension: >20 mmHg systolic drop on standing = dehydration, autonomic neuropathy, drugs

PILCODE APPLIED TO CARDINAL SYMPTOMS (MacLeod's Systematic Enquiry - Box 2.10)

CARDIOVASCULAR SYSTEM

Chest Pain

PILCODE	Application
P	Central/retrosternal (MI, angina, oesophageal) / Left-sided (pleuritic) / Tearing back pain (aortic dissection)
I	Severity 0-10; functional limitation; crushing/elephant-on-chest (ischaemia)
L	<20 min: stable angina / >20 min: unstable angina or NSTEMI/STEMI
C	Crushing/pressure (ischaemia) / Sharp positional (pericarditis, pleurisy) / Tearing (dissection) / Burning (GORD)
O	On exertion (stable angina) / At rest (unstable angina, NSTEMI) / Sudden maximal (dissection, PE, pneumothorax)
D	Radiation to jaw/arm/shoulder (MI)? Diaphoresis? Nausea? Dyspnoea? Fever (pericarditis, pneumonia)?
E	Relieved by GTN (angina) / Relieved by sitting forward (pericarditis) / Worse on inspiration (pleuritic)

Dyspnoea (Breathlessness)

PILCODE	Application
P	Cardiac vs. respiratory origin; use NYHA classification for severity
I	NYHA I (no limitation) to NYHA IV (symptoms at rest)
L	Acute (<24h: PE, pneumothorax, LVF) vs. chronic (COPD, heart failure, anaemia)
C	Orthopnoea (lying flat - HF, asthma) / PND (woken at night - LVF) / Wheeze (asthma, COPD)
O	Sudden: PE, pneumothorax, anaphylaxis / Gradual: COPD, heart failure, anaemia
D	Cough? Sputum? Haemoptysis? Ankle oedema? Weight gain? Palpitations? Smoking history?
E	Worse on lying flat? Triggered by allergens/cold? Improved with bronchodilators/diuretics?

RESPIRATORY SYSTEM

Cough

PILCODE	Application
P	Upper airway (dry, tickling - URTI, post-nasal drip) vs. lower airway (productive, deep)
I	Severity: interfering with sleep or daily activities? Haemoptysis (always serious)
L	Acute <3 weeks (URTI, pneumonia) / Subacute 3-8 weeks / Chronic >8 weeks (TB, cancer, GORD, ACE inhibitor)
C	Dry (ACE inhibitor, ILD, asthma) / Productive (pneumonia, COPD, bronchiectasis) / Barking (croup) / Whooping (pertussis)
O	Following URTI? Associated with new medication (ACE inhibitor)?
D	Sputum colour (yellow/green = infection, rusty = pneumococcal pneumonia) / Blood (TB, cancer, bronchiectasis, PE) / Fever? Weight loss? Night sweats?
E	Worse at night (asthma, GORD, post-nasal drip)? Worse with cold air? Positional?

GASTROINTESTINAL SYSTEM

Abdominal Pain

PILCODE	Application
P	RUQ (liver, gallbladder) / Epigastric (peptic ulcer, pancreatitis, aortic aneurysm) / RIF (appendix, ovary) / LIF (diverticulitis, sigmoid) / Loin (renal colic) / Generalised (peritonitis)
I	Severe colicky (renal/biliary colic - worst pain imaginable) vs. dull ache (inflammatory)
L	Acute (<24h: surgical emergency) vs. chronic/recurrent (IBS, IBD, peptic ulcer)
C	Colicky (comes and goes: bowel/ureteric obstruction, renal colic) / Constant (peritonitis, ischaemia) / Burning epigastric (peptic ulcer, GORD)
O	Sudden onset: perforation, ectopic pregnancy, mesenteric ischaemia / Gradual: IBD, appendicitis
D	Nausea/vomiting (before or after pain)? Bowel habit change? Rectal bleeding? Jaundice? Urinary symptoms? Menstrual history (female)?
E	Relieved by eating (duodenal ulcer: pain 2-3h after eating, relieved by food) / Worse after eating (gastric ulcer, mesenteric ischaemia) / Relieved by defecation (IBS)

NEUROLOGICAL SYSTEM

Headache

PILCODE	Application
P	Unilateral (migraine, cluster) / Bilateral (tension, raised ICP) / Occipital (hypertension, SAH) / Frontal (sinusitis, tension)
I	Thunderclap (worst headache ever - SAH until proven otherwise) / Gradual build-up (tension, migraine)
L	Episodic (migraine: 4-72h) / Daily (tension, analgesic overuse) / Progressive (raised ICP, malignancy)
C	Throbbing/pulsating (migraine) / Band-like pressure (tension) / Stabbing/drilling around eye (cluster) / Sudden explosive (SAH)
O	Thunderclap onset = SAH / Morning headache (raised ICP) / Triggered by foods/alcohol/stress (migraine)
D	Nausea/vomiting? Photophobia/phonophobia (migraine)? Neck stiffness + fever (meningitis)? Visual aura? Neurological symptoms?
E	Worse on coughing/bending (raised ICP) / Worse lying down (raised ICP - early morning) / Relieved by simple analgesia (tension)

MUSCULOSKELETAL SYSTEM

Joint Pain

PILCODE	Application
P	Single joint (monoarthritis: gout, septic arthritis, trauma) / Multiple joints (polyarthritis: RA, SLE, viral) / Axial vs. peripheral
I	VAS pain score; functional limitation (stairs, dressing, grip)
L	Acute (gout, septic arthritis) / Chronic (OA, RA) / Migratory (rheumatic fever, gonococcal arthritis)
C	Warm, red, swollen (inflammatory/infective) / Hard, bony swelling (OA - Heberden's nodes) / Morning stiffness >1 hour (RA, inflammatory)
O	Sudden overnight peak pain (gout) / Gradual (OA, RA)
D	Morning stiffness duration? Systemic symptoms (fever, rash, weight loss)? Skin changes (psoriatic arthropathy)? Eye symptoms (uveitis in AS)?
E	Worse after rest, improves with use (inflammatory: RA) / Worse with activity, better with rest (mechanical: OA)

Summary: MacLeod's Cardinal Symptoms by System (Box 2.10)

System	Key Cardinals
General	Weight change, fatigue, appetite, fever, night sweats
Cardiovascular	Chest pain, dyspnoea, orthopnoea, PND, palpitations, syncope, oedema, claudication
Respiratory	Dyspnoea, cough, haemoptysis, wheeze, stridor, pleuritic chest pain
GI	Abdominal pain, dysphagia, nausea/vomiting, change in bowel habit, rectal bleeding, jaundice
Urological	Dysuria, frequency, urgency, haematuria, loin pain
Neurological	Headache, seizures, weakness, numbness, visual change, syncope/blackout
Musculoskeletal	Joint pain, swelling, stiffness, back pain
Endocrine	Heat/cold intolerance, polydipsia, polyuria, weight change

Source: MacLeod's Clinical Examination 15th ed. (Dover, Innes, Fairhurst - Elsevier 2023), Chapter 2 - General Aspects of History Taking; Goldman-Cecil Medicine - Cardinal Symptoms of Cardiovascular Disease (Table 39-1); Roberts & Hedges' Clinical Procedures in Emergency Medicine - Vital Signs

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