II. Approach: Formulas and General Rules
- Systolic Blood Pressure in children over 1 year old
- Median SBP = 90 mmHg + (2 x Age in years)
- Minimum SBP = 70 mmHg + (2 x Age in years)
-
Heart Rate and Fever
- Expect Heart Rate to increase 7-10 bpm for each degree fahrenheit
- Rough Approximations
- Pulse or Heart Rate (HR)
- Systolic Blood Pressure (SBP)
- Infant SBP: 80
- Preschool SBP: 90
- Adolescent SBP: 100
- Respiratory Rate (RR)
- Infant RR: 40
- Preschool RR: 30
- Adolescent RR: 20
III. Indications: Rapid cardiopulmonary assessment (e.g. Pediatric Assessment Triangle)
- Systolic Blood Pressure is observed to drop 10 mm Hg
- Respiratory Rate >60
- Heart Rate outside ranges shown below
- Increased work of breathing
- Retractions
- Nasal Flaring
- Grunting
- Cyanosis or decreased Oxygen Saturation
- Altered LOC (irritability, lethargy)
- Seizures
- Fever with Petechiae
- Trauma
- Burns >10% of body surface area
IV. Evaluation: Age associated Vitals
-
Premature Infant
- Heart Rate: 120-170 bpm
- Blood Pressure: 55-75 / 35-45 mmHg
- Respiratory Rate: 40-70 breaths/min
- Term Newborn (3 kg)
- Temperature: 36.5 to 38.0 C (97.7 to 100.4 F)
- Mean arterial pressure (MAP): (Gestational age at birth) + (age in weeks)
- Example: An newborn at 38 weeks presents at 1 week of life, MAP = 39
- Blood Pressure:
- Birth: 75-95/37-55 mmHg
- Age 12 hours: 50-70 / 25-45 mmHg
- Age 96 hours: 60-90 / 20-60 mmHg
- Age 7 days: 74 +/- 22 mmHg (Systolic BP)
- Age 42 days: 96 +/- 20 mmHg (Systolic BP)
- Heart Rate: 100-150
- Respiratory Rate: 40-60
- Infant (0-3 months old)
- Heart Rate: 100-150 bpm
- Blood Pressure: 65-85 / 45-55 mmHg
- Respiratory Rate: 35-55 breaths/min
- Infant (3-6 months old)
- Heart Rate: 90-120 bpm
- Blood Pressure: 70-90 / 50-65 mmHg
- Respiratory Rate: 30-45 breaths/min
- Infant (6-12 months old)
- Heart Rate: 80-120 bpm
- Blood Pressure: 80-100 / 55-65 mmHg
- Respiratory Rate: 25-40 breaths/min
- Toddler (1-3 years old)
- Heart Rate: 70-110 bpm
- Blood Pressure: 90-105 / 55-70 mmHg
- Respiratory Rate: 20-30 breaths/min
- Preschool (3-6 years old)
- Heart Rate: 65-110 bpm
- Blood Pressure: 95-110 / 60-75 mmHg
- Respiratory Rate: 20-25 breaths/min
- School Age (6-12 years old)
- Heart Rate: 60-95 bpm
- Blood Pressure: 100-120 / 60-75 mmHg
- Respiratory Rate: 14-22 breaths/min
- Teen (>12 years old)
- Heart Rate: 55-85 bpm
- Blood Pressure: 110-135 / 65-85 mmHg
- Respiratory Rate: 12-18 breaths/min
V. References
- Claudius, Behar, Salway and Kearl in Herbert (2018) EM:Rap 18(5): 1-3
