Accurate monitoring and interpretation of vital signs is a core assessment skill for nurses working in the Emergency Department.
Patients are often acutely unwell and vital signs provide a clear indicator of their health status. It is, therefore, essential that nurses have knowledge of the normal range in vital signs in order for them to diligently monitor, record and interpret the data.
Abnormal changes to vital signs are often a prelude to patient deterioration. Thus, it is of great importance that changes are not overlooked and timely clinical decisions are made to prevent further clinical deterioration.
The following module includes a number of resources to help you understand the importance of measuring and recording vital signs accurately. It also explores recognising and responding to abnormal vital signs

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National Early Warning Score
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National early warning score is an aid to early detection of the detoriarating patient. it is not a substute for clinical holistic understanding. -
National Early Warning Score 2, Highs and lows
Why might NEWS criteria go up or down.
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National Early Warning Score 1, How to fill out.
Use the NEWS to moniter your patient's physiological condition.
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National Early Warning Score (NEWS2)
A standardised early warning system to identify patients at risk of acute deterioration
Short film featuring Professor Bryan Williams, about why the National Early Warning Score (NEWS2) was developed; how it can be used to identify sepsis and the benefits of a standardised early warning system. -
orientation to Early Warning Score EWS
Abnormal vital signs present major risks
In January 2009, an emergency nurse and the nurse’s hospital were found negligent for not making appropriate reassessments and failing to detect a worsening condition in a patient with a femoral arterial blockage. A $2.4 million verdict was returned.
https://www.reliasmedia.com/articles/113458-abnormal-vital-signs-present-major-risks
Changes and Abnormalities in Vital Signs: NCLEX-RN
The vital signs include the assessment of the pulse, body temperature, respirations, blood pressure and oxygen saturation, which is the newest of all the vital signs.
https://www.registerednursing.org/nclex/changes-abnormalities-vital-signs/
Do Vital Signs Wrong And Pay Ultimate Price
Vital signs matter. They matter most when done correctly and provide accurate data. Hence, why they are likely called “vital” signs.
https://www.acsh.org/news/2017/01/06/do-vital-signs-wrong-and-pay-ultimate-price-10689
“Can I take your vital signs?” Key learnings from 3 case studies
Failing to take vital signs, when appropriate, and to properly respond to abnormalities, have been identified as issues in many medico-legal cases.
https://www.cmpa-acpm.ca/en/advice-publications/browse-articles/2014/can-i-take-your-vital-signs-key-learnings-from-3-case-studies
Johnson, K. D., Mueller, L., & Winkelman, C. (2017). The nurse response to abnormal vital sign recording in the Emergency Department. Journal of Clinical Nursing, 26(1-2), 148-156. doi:10.1111/jocn.13425
Kellett, J., & Sebat, F. (2017). Make vital signs great again – A call for action. European Journal of Internal Medicine, 45, 13-19. doi:10.1016/j.ejim.2017.09.018
Lambe, K., Currey, J., & Considine, J. (2017). Emergency nurses’ decisions regarding frequency and nature of vital sign assessment. Journal of Clinical Nursing, 26(13-14), 1949-1959. doi:10.1111/jocn.13597