Vital signs in infants and children vary depending on their age; they are also different from those of adults. Pediatric vital signs include heart rate, breathing rate, blood pressure, and body temperature. Knowing these vital signs can help you notice any health concerns in your child.
Pediatric Vital Signs
There is not a specific range for each of the vital signs; however, many medical professionals have worked together to come up with an approximate range. Since there are many variables such as age, gender, height, level of anxiety, and the conditions in which the signs are tested, it is important to remember that a small amount of interpretation is acceptable.
Average Normal Values
|
Age |
Blood Pressure |
Heart Rate (beats/min) |
Respiratory Rate (beats/min) |
|
Premature |
55-75/35-45 |
120-170± |
40-70 |
|
0-3 months |
65-85/45-55 |
100-150± |
35-55 |
|
3-12 months |
70-100/50-65 |
80-120 |
25-45 |
|
1-6 years old |
90-110/55-75 |
65-110 |
20-30 |
|
6-12 years old |
100-120/60-75 |
60-95 |
14-22 |
|
12+ years old |
110-135/65-85 |
55-85 |
12-18 |
Acceptable Ranges for Unwell Children
The following is a table of ranges for pediatric vital signs which may need medical attention. Keep in mind that there is still a lot of uncommon ground within pediatric medicine; this is why the ranges may overlap those previously mentioned as being healthy ranges.
|
Age |
Weight (Kg) |
Systolic Blood Pressure (mmHg) |
Heart Rate (beats/min) |
Respiratory Rate (breaths/min) |
|
Term |
3.5 |
60-105 |
110-170 |
25-60 |
|
0-6 months |
6-8 |
65-115 |
105-165 |
25-55 |
|
1 – 4 years |
10-15 |
70-120 |
85-150 |
20-40 |
|
5 – 10 years |
20-30 |
80-130 |
70-135 |
16-34 |
|
12-17 years |
40-70 |
95-140 |
60-120 |
14-26 |
How to Get the Values of Pediatric Vital Signs
1. Temperatures
Although you can use any form of temperature measurement (rectal, oral, axillary, and tympanic), you need to be cautious. Some may cause more injury than others.
Use the measurement method that makes the most sense depending on the amount of accuracy you need. There are some times when you do not need a 100% accurate reading to make a quick diagnosis. Below you will find the method that works best for each age group.
|
Age |
How to Take |
|
Infant |
Rectal – Lay the infant prone on a parent's lap, use your thumb and index finger to separate the buttocks. Then insert the tip of the lubricated thermometer about 2 centimeters. Hold the infant still to prevent any damage. |
|
Toddlers or preschoolers |
Axillary – Place the thermometer in the center of the armpit and firmly hold the arm at the side. Leave in place until it beeps or one minute is up. |
|
School-age children |
Tympanic – You need to straighten the ear canal; if the child is older than three, pull the pinna up and back, if the child is younger than three pull it down and back. Gently place the tip into the opened ear canal and wait a few seconds for the temperature to display. Be sure that the probe is at the proper angle and do not use if the ear is in pain or full of earwax. |
|
Adolescents |
Orally – Place the thermometer under the tongue and instruct the child to keep their mouth closed around the thermometer and not to bite down until the time is up. You can either time for one minute or use a thermometer with a beeper. |
2. Pulse (Heart Rate)
It is common for infants to have higher heart rates because they are unable to stretch their myocardial fibers and rely solely on their heart rate. However, when older infants and children have higher heart rates, it may be an indication of a health ailment such as fever, anxiety, hypothermia, congenital heart problems, and many others.
When taking any heart rate, or pulse, it is important to make sure the child is at rest and has been resting beforehand to get a more accurate measurement.
|
Age |
How to Take |
|
Infant |
Auscultate the apical impulse – warm the bell of the stethoscope and place over the infant's heart. Count for one full minute at this age because there may be irregular heartbeats. The most accurate measurement will be done while the infant is sleeping. |
|
Toddlers or preschoolers |
Radial pulse – place the pads of your fingers inside the groove that runs long the thumb side of the child's inner wrist. Then, apply a light amount of pressure and count for 30 seconds then multiply by two. |
|
School-age children |
Radial pulse – Follow the first part above, then count for 6 seconds and multiply by ten. |
|
Adolescents |
Radial pulse – same as above. Apical – Use this location if the child may have cardiovascular problems. Use a stethoscope at the apex of the heart. Then, count for a full minute. |
3. Respiration
Respiration is one of the pediatric vital signs that needs assessing. Assessing respiration involves observing the rate, depth, and rhythm of the chest as the child breaths. Taking these measurements can help ensure the child is healthy. Having rapid or shallow respirations can be indicators of many health conditions.
|
Age |
How to Take |
|
Infant |
It is best to test an infant's respiration when they are sleeping. The respirations will be mostly in the diaphragm so you need to observe the abdominal movements for one full minute. There can be up to 10 breaths per minute if the infant has a fever. |
|
Toddlers or preschoolers |
Count the respiratory rate in children as you would in an adult. Do not let the child know so that their breathing is not altered. |
|
School-age children |
Evaluation techniques do not vary much; simply try to count while they are unaware. |
|
Adolescents |
Measure as you would with school-age children. |
4. Blood Pressure
Blood pressure is important at every age. Most of the time it is thought of as a measurement for adults, but high and low blood pressures in children can also indicate health problems.
- It is important that you use an appropriate sized cuff for the child because their arms vary greatly in size. If the cuff is too small, the blood pressure will read higher than it is; and if the cuff is too big, it will read lower than it is.
- You should also have children over three years of age tested yearly as they are continuing to grow and are prone to health ailments.
|
Age |
How to take |
|
Infant |
Blood pressure in infants only needs to be tested once by the age of 1, unless there are special health conditions that require it. When you do take an infant's blood pressure, a Doppler device is the best to use. |
|
Toddlers or preschoolers & school-age children |
The tightening of the cuff can be scary, so it is important that you prepare this age group ahead of time. The limb being used needs to be at heart level. Inflate the cuff rapidly to 20 mmHg, then release the cuff at 2-3 mmHg/sec. Listen with a stethoscope as you release the cuff, the first Korotkoff sound is the systolic pressure and the fourth is the diastolic pressure. |
|
Adolescents |
Blood pressure in this age group is done the same as it is for adults. The first Korotkoff sound is the systolic pressure and the fifth Korotkoff sound is the diastolic pressure. |