Pediatrics

Vitals by age

A heart rate of 150 is normal at 3 months and alarming at 15 years. Pick the band, read its ranges and what makes them different, then read four real sets of numbers in context.

Infant · 1 to 12 months

Heart rate, awake: 100 to 180; per minute
Respiratory rate: 30 to 53; per minute
Hypotension (systolic): below 70; mmHg at 1 y
Saturation: 97 to 100; well child; oxygen below 90
Fever: 38.0 or above; hypothermia below 36.0

What is different at this age

Infants compensate with heart rate and respiratory rate long before blood pressure falls; a normal pressure is not reassurance. Work of breathing and feeding are the vital signs the number set does not print.

Teaching ranges from the American Heart Association PALS 2020 tables (Fleming 2011 centiles); hypotension is the PALS 5th percentile: 60 in term neonates, 70 in infants, 70 + 2 x age in years from 1 to 10, 90 from 10 years. Not decision support: read every child in context.

Read the set

Which number needs attention, in context?

18 monthsBrought with a fever and a cough since yesterday. Playing with a toy on the bed, drinking.

HR162highRR42highSBP96SpO297T39.2high

Which vital sign requires the most attention, in context?

3 weeksBrought because 'he is not feeding like before'. Sleepy, difficult to wake for the examination.

HR96lowRR28lowSBP62SpO296T35.8low

Which finding most requires attention?

7 yearsTwo days of vomiting and diarrhea. Lying quietly, hands cool, capillary refill 4 seconds, last urine this morning.

HR146highRR30highSBP84SpO298T37.4

Read the set.

15 yearsSports physical. Fit, asymptomatic, plays competitive soccer.

HR52lowRR12SBP108SpO299T36.6

Read the set.

Quick fire

Normal for age?

0/0 · 10 items

2 yearsVital sign

Systolic blood pressure 78