#ir #peds
The HR can be determined by feeling a peripheral pulse, or by direct
auscultation of the heart to determine an apical rate. For accurate measurement, you
can count the pulse for 30 seconds and then multiply this number by two. You may also
get the heart rate from an external monitor, pulse oximeter or blood pressure machine,
but you can gain additional information by feeling the strength, contour and regularity of
a pulse. A heart rate should be measured when a patient is either at rest or asleep.
Separate reference ranges exist for children who are awake and sleeping.
Trends with Age: Resting heart rate is fastest in infants and decreases with age. A
normal HR for an awake, healthy term newborn is between 85 and 205 bpm. As a child
gets older, their HR will slowly decrease until age 10 where it approximately reaches
normal adult values. A normal HR for a child older than 10 years is between 60 and
100 bpm.
Tachycardia, or an elevated heartrate could suggest a cardiac arrhythmia, hypovolemia,
a metabolic disturbance, infection or more. Sinus bradycardia during sleep is very
common in infants and children; as long as they are pink and well perfused there is
rarely cause for worry. Children with bradycardia during awake periods should be
evaluated for an underlying abnormality to the heart’s conduction system such as a third
degree heart block
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Approach to Pediatric Vital Signs dating
back to Ancient Egypt in 3500 BC where physicians would use the pulse as a sign of
advancing disease. The heart rate is of equal importance today and can tell us much
about a patient’s clinical status.
Measurement: <span>The HR can be determined by feeling a peripheral pulse, or by direct
auscultation of the heart to determine an apical rate. For accurate measurement, you
can count the pulse for 30 seconds and then multiply this number by two. You may also
get the heart rate from an external monitor, pulse oximeter or blood pressure machine,
but you can gain additional information by feeling the strength, contour and regularity of
a pulse. A heart rate should be measured when a patient is either at rest or asleep.
Separate reference ranges exist for children who are awake and sleeping.
Trends with Age: Resting heart rate is fastest in infants and decreases with age. A
normal HR for an awake, healthy term newborn is between 85 and 205 bpm. As a child
gets older, their HR will slowly decrease until age 10 where it approximately reaches
normal adult values. A normal HR for a child older than 10 years is between 60 and
100 bpm.
Tachycardia, or an elevated heartrate could suggest a cardiac arrhythmia, hypovolemia,
a metabolic disturbance, infection or more. Sinus bradycardia during sleep is very
common in infants and children; as long as they are pink and well perfused there is
rarely cause for worry. Children with bradycardia during awake periods should be
evaluated for an underlying abnormality to the heart’s conduction system such as a third
degree heart block.
Respiratory Rate
The respiratory rate is unique in that is the one vital sign that we can consciously
control. A person can hold their breath, or purposefully breathe fa Summary
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