Pediatric Respiratory Rates Age Rate (breaths per minute)

Infant (birth1 year) 3060 Toddler (13 years) 2440 Preschooler (36 years) 2234 School-age (612 years) 1830 Adolescent (1218 years) 1216

Pediatric Pulse Rates Age Low High

Infant (birth1 year) 100 160 Toddler (13 years) 90 150 Preschooler (36 years) 80 140 School-age (612 years) 70 120 Adolescent (1218 years) 60 100

Pulse rates for a child who is sleeping may be 10 percent lower than the low rate listed. Low-Normal Pediatric Systolic Blood Pressure Age* Low Normal
Infant (birth1 year) greater than 60* Toddler (13 years) greater than 70* Preschooler (36 years) greater than 75 School-age (612 years) greater than 80 Adolescent (1218 years) greater than 90

*Note: In infants and children aged three years or younger, the presence of a strong central pulse should be substituted for a blood pressure reading. Pediatric CUPS Assessment Category Assessment Actions Example Critical Absent airway,
breathing, or circulation Perform rapid initial interventions and transport simultaneously Severe traumatic injury with respiratory arrest or cardiac arrest Unstable Compromised airway, breathing, or circulation with altered mental status Perform rapid initial interventions and transport simultaneously Significant injury with respiratory distress, active bleeding, shock; near-drowning; unresponsiveness

Potentially unstable
Normal airway, breathing, circulation, and mental status BUT significant mechanism of injury or illness Perform initial assessment with interventions; transport promptly; do focused history and physical exam during transport if time allows Minor fractures; pedestrian struck by car but with good appearance and normal initial assessment; infant younger than three months with fever Stable Normal airway, breathing, circulation, and mental status; no significant mechanism of injury or illness Perform initial assessment with interventions; do focused history and detailed physical exam; routine transport Small lacerations, abrasions, or ecchymoses; infant older than three months with fever
Based on CUPS Assessment Table 1997 N. D. Sanddal, et al. Critical Trauma Care by the Basic EMT, 4th ed.

Developmental Aspects of Pediatric Patients Age* Keys to Successful Interaction Characteristics

Newborn (birth to 1 month) Likes to be held and kept warm May be soothed by having something to suck on Avoid loud noises, bright lights Normally alert, looking around Focuses well on faces Flexed extremities Infant (112 months) Likes to be held Parents should be nearby

Examine from toes to head Distract with a toy or penlight Normally alert, looking around Eyes follow examiner Slightly flexed extremities Can straighten arms and legs Can sit unaided by 68 months Toddler (13 years) Make a game of assessment Distract with a toy or penlight Examine from toes to head Allow parents to participate in exam Respect modesty, keep child covered when possible Normally alert, active Can walk by 18 months Does not like to sit still May grab at penlight or push hand away Preschooler (36 years) Explain actions using simple language Tell child what will happen next Tell child just before procedure if something will hurt Distract child with a story Respect modesty Normally alert, active Can sit still on request Can cooperate with examination Understands speech Will make up explanations for anything not understood School-age child (612 years) Respect modesty Let child make treatment choices when possible Allow child to participate in exam Will cooperate if trust is established Wants to participate and retain some control Adolescent (1218 years) Explain the process as to an adult Treat the adolescent with respect Has clear concepts of future Can make decisions about care *Note that children who are frightened or in pain may act younger than their age

Pediatric Vital Sign Normal Ranges

Age Group Newborn Infant (1-12 months) Toddler (1-3 yrs.) Preschooler (3-5 yrs.) School Age (6-12 yrs.) Adolescent (13+ yrs.) Respiratory Heart Rate Rate 30 - 50 20 - 30 20 - 30 20 - 30 20 - 30 12 - 20 Systolic Weight Weight Blood in in kilos Pressure pounds 2-3 4.5 - 7 9 - 22

120 - 160 50 - 70

80 - 140 70 - 100 4 - 10

80 - 130 80 - 110 10 - 14 22 - 31 80 - 120 80 - 110 14 - 18 31 - 40 70 - 110 80 - 120 20 - 42 41 - 92 55 - 105 110 120 >50 >110

REMEMBER:

The patient's normal range should always be taken into consideration. Heart rate, BP & respiratory rate are expected to increase during times of fever or stress. Respiratory rate on infants should be counted for a full 60 seconds. In a clinically decompensating child, the blood pressure will be the last to change. Just because your pediatric patient's BP is normal, don't assume that your patient is "stable". Bradycardia in children is an ominous sign, usually a result of hypoxia. Act quickly, as this child is extremely critical.