Reference — Neonatal & Pediatric
Pediatric Vital Signs & Normal Values
Age-banded normal values for the pediatric patient — respiratory rate, heart rate, and systolic blood pressure from newborn through adolescent, plus SpO₂ targets, weight estimation, and the hypotension thresholds that signal decompensation.
Written by Apex Respiratory Editorial Team
Educational use only. This material supports respiratory therapy education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional protocols, or physician orders. Always follow facility policies and current provider orders, and verify calculations independently before clinical use.
Overview
Pediatric “normal” depends on age. These ranges anchor the recognition of distress and the cutoffs — especially for hypotension — that mark decompensated shock. Use them alongside the clinical picture and the child’s own baseline; published ranges vary by source and shift with fever, pain, and crying.
Normal Respiratory & Heart Rate by Age
| Age Group | Respiratory Rate (/min) | Heart Rate (/min) |
|---|---|---|
| Newborn (0–1 mo) | 30 – 60 | 100 – 180 |
| Infant (1–12 mo) | 25 – 50 | 100 – 160 |
| Toddler (1–2 yr) | 20 – 40 | 90 – 150 |
| Preschool (3–5 yr) | 20 – 30 | 80 – 140 |
| School age (6–12 yr) | 18 – 25 | 70 – 120 |
| Adolescent (13–18 yr) | 12 – 20 | 60 – 100 |
Values are for the awake child at rest.
Systolic Blood Pressure & Hypotension Threshold
| Age | Normal Systolic (mmHg) | Hypotension (Systolic Below) |
|---|---|---|
| Term neonate | ~60 – 90 | 60 |
| Infant (1–12 mo) | ~70 – 100 | 70 |
| Child (1–10 yr) | varies | 70 + (2 × age in years) |
| Child (over 10 yr) | ~90 – 120 | 90 |
Other Quick Values
| Parameter | Value |
|---|---|
| SpO₂ target | at least 94% for most children; a 90–95% band in preterm neonates (to avoid ROP); cyanotic congenital heart disease has its own baseline |
| Estimated weight (1–10 yr) | (age in years × 2) + 8 kg, or use a length-based resuscitation tape |
| Circulating blood volume | about 80 mL/kg (neonate ~85–90) |
| Normal urine output | infant about 2 mL/kg/h; child about 1 mL/kg/h |
Clinical Notes
- Hypotension is a LATE sign in children. They defend blood pressure with tachycardia and vasoconstriction until they suddenly decompensate. Tachycardia plus poor perfusion (capillary refill over 2 seconds, weak pulses, mottling) signals compensated shock before the blood pressure falls.
- Bradycardia in a sick child usually means hypoxia. Oxygenate and ventilate.
- Use a length-based tape in an emergency. A length-based (Broselow-type) tape estimates weight and equipment size more reliably than memory.
- Values differ between sources. Ranges vary between sources (for example PALS versus APLS) and change with fever, pain, and crying — trend and context matter more than a single number.
Related Resources
Sources
- Kacmarek RM, Stoller JK, Heuer AJ. Egan's Fundamentals of Respiratory Care. 12th ed. Elsevier; 2021. Pediatric assessment chapters.
- Topjian AA, Raymond TT, Atkins D, et al. Part 4: Pediatric Basic and Advanced Life Support: 2020 American Heart Association Guidelines for CPR and Emergency Cardiovascular Care. Circulation. 2020;142(16_suppl_2):S469-S523.