VITALS are a standardized framework for reviewing acute care charts that aids occupational therapists in making informed clinical decisions before interacting with a patient.

  • Standard nasal cannula: low flow oxygen, 1–6 L/min.

    Venturi mask: high-flow enriched oxygen of a certain concentration. Provides FiO2 24%–40%.

    Face mask: used for patients with nasal irritation. Provides FiO2 40%–60%.

    Nonrebreathing face mask: Provides high concentrations of oxygen. Delivers FiO2 up to 90%.

    Reservoir cannula: improves the efficiency of oxygen delivery (i.e., patients may be well oxygenated at lower flows).

    High-flow warmed and humidified oxygen (HFNC): nasal or transtracheal. Delivers oxygen comfortably at high flows ranging from 30–60 L/min.

    Continuous positive airway ventilation (CPAP): provides continuous positive pressure to maintain an open airway.

    Bi-level positive airway ventilation (BiPAP):
    Mechanical ventilation: a lifesaving intervention for patients with respiratory failure.

    • Chest x-ray (to identify pulmonary edema).

    • Ultrasound (ruling out for DVT).

    • Magnetic resonance imaging (identifying a brain bleed).

    • Computed tomography (determining presence of pulmonary embolism).

    • Central venous line (CVL)

    • Arterial line (A-line)

    • Venous and arterial femoral catheters

    • Femoral hemodialysis catheter

    • Femoral intra-aortic balloon pump (IABP)

    • Pulmonary artery catheter (e.g., Swan-Ganz)

    • Transvenous or epicardial pacemaker

    • Extracorporeal membrane oxygenation (ECMO)

    • Continuous renal replacement therapy (CRRT)

    • Endotracheal tube (ETT)

    • Tracheostomy tube (“Trach”)

    • Bedrest: (Bedrest might be indicated in the case of new DVT or PE, CSF leak, or new internal bleed.)

    • Out of bed

    • Out of bed to chair

    • Other

    • Heart Rate: 50-120 bpm

    • Systolic Blood Pressure: 80-180 mmHg

    • Diastolic Blood Pressure: 40-110 mmHg

    • SPO2%: Above 90%

    • Respirations: 12-20 breaths per minute

    • Mean Arterial Pressure (MAP): 70-105 mmHg

    • Vasopressors (e.g., norepinephrine, phenylephrine, vasopressin): Consider medical hold when doses are increasing, MAP is <60 or if patient is on >2 pressors.

    • Sedatives (e.g., propofol, dexmedetomidine, fentanyl): Consider medical hold if patient is obtunded or medical team is unable to safely reduce sedation for therapy.

References

Smith-Gabai, Helen, Holm, Suzanne. (2017). Occupational Therapy in Acute Care. AOTA Press.

Millar, Stacy. Lab values in acute care therapy. Allied Health Ed. https://alliedhealthed.com/wp-content/uploads/2021/01/Lab-Values-Handout.pdf