The pediatric vital signs (respiratory rate, pulse rate, and blood pressure) give critical information about the condition of child having trouble breathing or having unusual drowsiness, irritability, confusion, or coma.
The following tables are from the 2006 edition of Pediatric Advanced Life Support.
Normal Respiratory Rates by Age
Age Breaths per Minute
Infant (less than one year) 30 to 60
Toddler (1 to 3 years) 24 to 40
Preschooler (4 to 5 years) 22 to 34
School Age (6 to 12 years) 18 to 30
Adolescent (13 to 18 years) 12 to 16
If a child of any age is breathing faster than 60 breaths per minute, this is abnormal and needs to be evaluated urgently. A breathing rate of below normal also needs to be evaluated urgently and may mean impending respiratory arrest. The treatment for impending respiratory arrest is to help the infant or child breath intially with bag-mask ventilation.
Normal Heart Rates (Pulses) per minute by age
Age Awake Rate Mean Sleeping rate
Newborn to 3 months 85 t0 205 140 80 to 160
3 months to 2 years 100 to 190 130 75 to 160
2 years to 10 years 60 to 140 80 60 to 90
greater than 10 years 60 to 100 80 50 to 90
To find the heart rate check the pulse, listen to the heart with a stethoscope, or view the heart rate on a monitor.
A faster than normal heart rate is called a tachycardia and a slower than normal heart rate is called a bradycardia. Fever, pain, and anxiety can cause a rapid heart rate (tachycardia) as can respiratory distress, respiratory failure, shock, and abnormal heart rythms. The most important cause of a slow heart rate is abnormally low oxygen in the blood. A slow heart rate in an infant or child struggling to breath requires immediate help to breath (usually with bag-mask ventilatory support).
Abnormally Low Blood Pressure (Hypotension) by age
Age Systolic Blood Pressure (mm Hg)
Term Neonate (0 to 28 days) Less than 60
Infants (1 to 12 moths) Less than 70
Children (1 to 10 years) Less than 70 plus 2 times the age in years
Children ( greater than 10 years) Less than 90
The blood pressure consists of two numbers: an upper or higher number called the systolic blood pressure and a lower number or bottom number called the diastolic blood pressure. In a seriously ill child we direct our therapy at the low systolic number. Low systolic blood pressure in a child means decompensated shock (inadequate blood flow to meet the needs the body). A child in decompensated shock needs vigorous intravenous fluid administration and airway and breathing treatment to prevent cardiac arrest.
