WHAT AND WHAT ARE PEDIATRIC VITAL SIGNS? - MEDICINE - 2025

The vital signs pediatric are the minimum basic measurements of basic bodily functions of infants, preschool and school. The body expresses the functionality of the patient's organs and systems through vital signs.

Some of the most important vital signs in children are respiration, circulation, and metabolism. The ease of obtaining vital signs lies in the possibility of doing it routinely in the physical examination and with simple instruments.

Any alteration in vital signs can signify physiological or pathological changes, depending on the change evidenced.

What are the main vital signs in children?

There are five main pediatric vital signs: respiratory rate, heart rate, body temperature, blood pressure, and pulse oximetry.

- Breathing frequency

It refers to the number of times the child breathes per minute. It is usually measured while at rest and varies according to the age of the patient.

- 0 days to 2 months: 60 breaths per minute.

- 2 months to 1 year: 50 breaths per minute.

- 1 year to 4 years: 40 breaths per minute.

- 4 years to 8 years: 30 breaths per minute.

When it is evaluated as a vital sign, the pulmonary cycle carried out by the oxygen that is inhaled and the carbon dioxide that is exhaled is taken into account.

This process of inhalation and exhalation, or inspiration and expiration, occurs thanks to the cyclical contraction and relaxation of the respiratory muscles.

These values ​​may be altered in conditions in which the child's metabolic needs increase, such as in exercise, when there are high body temperatures, intense pain, or ascent to high altitudes.

- Heart rate

It refers to the pressure wave caused by the passage of blood through an artery.

It cannot be measured in any artery: it must be a superficial artery, with a nearby bone or muscle surface where the examiner's finger can rest in order to distinguish the pulsatile wave.

This wave originates with the contraction of the left ventricle of the heart. It is a reliable measure, except in cases where the child has a diagnosis of cardiac arrhythmias; in these cases the central heart rate may be higher than the peripheral one.

Central heart rate

It refers to the number of times the heart contracts or beats in one minute. It is assessed using a stethoscope by auscultation.

Peripheral heart rate

It refers to the number of perceptible pulsatile waves in a peripheral artery in one minute. It is evaluated using the fingers on the artery and on some bone surface.

- Blood pressure

Blood pressure refers to the pressure exerted by the blood against the artery walls. It depends on the volume per minute and the tone of the arterial walls.

It is measured using a sphygomanometer or blood pressure monitor, and a stethoscope. Like the heart and respiratory rates, their normal values ​​vary according to the age group.

There is a physiological increase in blood pressure according to advancing age. In the first years of life the ascent is rapid and then it slows down.

An increase in blood pressure above the expected values ​​according to the age range is called arterial hypertension.

On the other hand, the reduction of this figure below the expected values ​​for the age group under study is called arterial hypotension.

- temperature

It is the measurement of the amount of body heat. Shows the relationship between the amount of heat produced and the amount of heat lost.

A fever is considered when the body temperature is greater than or equal to 38.3 ° C. It can be taken by different routes: oral, rectal or axillary.

There is also the tympanic route, which consists of the use of an otic thermometer that works by means of an infrared system.

The most reliable temperature and that most accurately reflects the real body temperature is the one taken rectally.

There are multiple causes of fever: from viral or bacterial infections, hyperthyroidism, neoplasms, physical stress (strenuous exercise, inflammatory diseases), among others.

- Pulse oximetry

It refers to the measurement of oxygen transported through capillaries. This measurement is not invasive, as a pulse oximeter or a saturation meter is used, in the form of a clamp, which is placed on the index finger.

This pulse oximeter uses spectrophotometry by emitting light with two wavelengths: for oxyhemoglobin and reduced hemoglobin.

It also allows to know the measurement of transported oxygen, the arterial pulse and the curve of said pulse.

Pulse oximetry measures oxygen saturation in the blood, but does not measure other values ​​such as pressure of oxygen and carbon dioxide, which can only be reflected in arterial blood gases.

The measurement of all vital signs allows us to know the vitality and correct biological functioning of pediatric patients, not only in the emergency area but also in the consultation of a healthy child.

An alteration in any of these measurements leads to an exhaustive study to determine its cause.

References

1. Gastrohnup Magazine Year 2011 Volume 13 Number 1 Supplement 1: S58-S70 Recovered from: revgastrohnup.univalle.edu.co
2. University of Rocjester Medical Center. Health Encyclopedia. Vital signs. Recovered from: urmc.rochester.edu
3. Kliegman, RM, et al. Nelson Textbook of Pediatrics, 20th Edition. Philadelphia, PA: Elsevier, 2015
4. Weaver, Donald J. "Hypertension in Children and Adolescents." Pediatrics in Review 38.8 August 2017: 369-382.
5. Heart and vascular institute. The George Washington University. Vital signs. Recovered from: gwheartandvascular.org.