Vital Signs and Observation: Medical Basics for Kaigo Care Workers

Medical care（医療的ケア）· Material

バイタルサインと観察の基本 · Updated 26 October 2026

The 医療的ケア field tests a care worker's ability to work with medical staff: measuring and reading vital signs （バイタルサイン）, observing changes in condition （観察）, and reporting them quickly. Care workers are at the user's side every day, so they are often the first to notice a small change before it becomes serious.

The four main vital signs

The main vital signs are body temperature （体温）, pulse （脈拍）, breathing （呼吸）, and blood pressure （血圧）, plus observation of the level of consciousness （意識レベル）. Measure them in the correct way and at consistent times so results can be compared.

General reference values for adults: temperature 36–37°C, pulse 60–100 per minute, breathing 12–20 per minute. In older people, baseline temperature tends to be slightly lower and the fever response to infection is often weak, so the absence of fever is no guarantee that there is no infection.

• 体温・脈拍・呼吸・血圧 + level of consciousness
• Older people: lower baseline temperature, fever may not appear
• Measure the same way at consistent times

A person's usual values are the most important reference

Textbook normal figures are only a general guide. What matters most is comparison with that person's usual values （ふだんの値）: a blood pressure that is "normal" for someone else may mean a sharp drop for a person who is usually high.

Measurement results should therefore be recorded every time, shared with the team including nursing staff, and any change from the usual pattern treated as important information even when the figure is still within the normal range.

• Compare with ふだんの値 (that person's usual values)
• Record and share every measurement result
• A change in pattern = important information, even if still "normal"

Danger signs that must be reported immediately

Changes that must be reported at once include: reduced consciousness or unusual restlessness, rapid breathing or breathlessness, a very fast, weak, or irregular pulse, high fever or conversely a very low temperature, urine stopping, and skin turning blue or very pale.

Reports go immediately to the nurse or the person in charge, with measured data (the vital-sign figures and the time of the event), not general impressions. The principle is early detection and early response （異常の早期発見・早期対応）.

• Watch for: falling consciousness, breathlessness, disordered pulse, urine stopping
• Report with figures and times, not impressions
• 異常の早期発見： detect and respond as early as possible

The scope of medical acts for care workers

Under the system in place since 2012, care workers who have completed the special training and are registered as 認定特定行為業務従事者 may perform two limited medical acts: suctioning of sputum （喀痰吸引） and tube feeding （経管栄養）, under the specified conditions and supervision. Beyond that, giving medication and other medical acts are the responsibility of medical professionals.

In daily work, a care worker's medical role is infection prevention through standard precautions （スタンダードプリコーション， with hand hygiene as the basis), continuous observation, and acting as a bridge of information between users, families, and the medical team.

• 喀痰吸引 and 経管栄養： only by trained, registered care workers
• スタンダードプリコーション： hand hygiene is the basis
• Daily role: observation, infection prevention, reporting

Key terms

Frequently tested points

• In older people, a serious infection can occur without fever — never use temperature as the only yardstick.
• The most important reference is the person's usual values, not just the textbook normal range.
• 喀痰吸引 and 経管栄養 may only be performed by trained, registered care workers （認定特定行為業務従事者）.
• A report of a condition change must include measured figures and the time of the event.

Independent study material for the Japanese national Certified Care Worker exam (介護福祉士国家試験). Official terms and rules may change — always cross-check with the latest official sources.