#ir #peds
vitals case:
Your patient is a 12-month old boy admitted with
bronchiolitis. His vitals include HR of 120, RR of 36, BP of 85/37, tympanic temperature
of 36.60
C and SPO2 of 92% on room air. You first walk into the room and assess the
clinical picture. The baby is resting peacefully on room air, with only some mild
Developed by Chris Novak, Dr. Mel Lewis and Dr. Peter Gill for pedscases.com
February 15, 2015
expiratory wheeze noted. You review a reference table and find the following. A normal
heart rate for a child 1 year of age is between 100 and 190 bpm, therefore his heartrate
of 120 is comfortably within normal limits for a child his age. A normal respiratory rate
for his age would be between 24 and 40 bpm. His respiratory rate of 36 is at the high
end of normal, which is in keeping with his diagnosis of bronchiolitis. Using a blood
pressure calculator, you find that his blood pressure is at the 50th percentile for his age,
height and gender. He is afebrile. His oxygen saturation is low, but on the border of
what might be concerning. In summary, the child has stable vital signs, but may need a
few more days of supportive care before he is back to full health.
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Approach to Pediatric Vital Signs(SPO2) values have not yet been firmly established.
Generally, a SPO2 of <92% should be a cause of concern and may suggest a
respiratory disease or cyanotic heart disease.
Conclusion
Now let’s review our clinical case – <span>Your patient is a 12-month old boy admitted with
bronchiolitis. His vitals include HR of 120, RR of 36, BP of 85/37, tympanic temperature
of 36.60
C and SPO2 of 92% on room air. You first walk into the room and assess the
clinical picture. The baby is resting peacefully on room air, with only some mild
Developed by Chris Novak, Dr. Mel Lewis and Dr. Peter Gill for pedscases.com
February 15, 2015
expiratory wheeze noted. You review a reference table and find the following. A normal
heart rate for a child 1 year of age is between 100 and 190 bpm, therefore his heartrate
of 120 is comfortably within normal limits for a child his age. A normal respiratory rate
for his age would be between 24 and 40 bpm. His respiratory rate of 36 is at the high
end of normal, which is in keeping with his diagnosis of bronchiolitis. Using a blood
pressure calculator, you find that his blood pressure is at the 50th percentile for his age,
height and gender. He is afebrile. His oxygen saturation is low, but on the border of
what might be concerning. In summary, the child has stable vital signs, but may need a
few more days of supportive care before he is back to full health.
This concludes our podcast. Before we leave, here are a few take-home points:
1) Pediatric vital signs vary with age, and it is important to use age-adjusted
reference va Summary
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